434 VETERINARY SURGICAL OPERATIONS 



ception may be made of very small growths whose entire 

 surroundings could be anaesthetized with cocaine solution. 

 INSTRUMENTS, ETC.— 

 i. Scalpel and scissors. 



2. Dissecting forceps. 



3. Artery forceps, several. 



4. Tenacula (two) or two tumor forceps. 



5. Thermo-cautery. 



6. Needle and braided silk sutures. 



7. Razor and clipper. 



8. Antiseptic solutions. 



ANTISEPTICS.— Ordinary antisepsis, indicated for dis- 

 sections in general, is essential. This includes sterilization 

 of the instruments, cleansing of the field and disinfection of 

 the hands. 



PRE-OPERATIVE PREPARATION.— The cleansing, 

 shaving and disinfection should precede casting, and as this 

 is being done the proposed lines of incision to make the 

 resection of an elliptical section of skin (see step 1) are 

 marked out by snipping the skin here and there along the 

 course with the scissors. This is necessitated by the changed 

 relation of the skin to the growth when the patient is re- 

 cumbent. If this trivial matter is not respected the sutured 

 incision, when the horse regains the standing position after 

 the operation, may be found to be markedly oblique instead 

 of vertical. 



TECHNIQUE.— First Step.— The Cutaneous Resection. 

 — An elliptical piece of skin is resected perpendicularly across 

 the whole growth, following the lines previously marked out. 

 The width of the section must vary according to the amount 

 of redundant skin that will result from the dissection, and it 

 must in addition include within its area all of the orifices of 

 fistulous tracts the growth may contain. 



Second Step. — Dissection of the Growth. — The growth 

 is then grasped with the tenaculum or tumor forceps and 

 drawn up firmly by an assistant as the skin is carefully dis- 

 sected loosely around the entire surface. As the growth is 

 composed largely of hypertrophied corium the separation 

 can only be done by sharp dissection which is carried as near 

 to the epiderm as possible. A thick flap is avoided, but care 

 must be taken not to "button-hole" the flaps as the dissection 

 proceeds. * 



Spurting vessels encountered are "touched up" with the 

 thermo-cautery or twisted with the haemostatic forceps. 



When the dissection has reached the base of the growth 



