ABLATION OF SHOE-BOILS 



435 



its remotest boundaries are sought in order that every vestige 

 of the hypertrophied tissue be removed. Beginning- above, 

 the growth is then detached from the elbow to which it is 

 attached by loose areolar tissue. At this point of the dis- 

 section, the nutrient vessels, if observed, are ligated, but if 

 they escape notice the ligation or torsion follows the ablation. 

 Third Step. — Haemostasis. — The success of the operation 

 depends much upon the thoroughness with which the bleed- 

 ing is controlled before the flaps are united by sutures. To 

 simply suture the flaps and then leave the cavity to fill up 

 with a large blood clot destroys the chances of success. The 

 bleeding is patiently combated with forceps, ligatures and 



Fig. 223— Wound Properly Sutured after Ablation. 

 (Bayer & Frohner.) 



the thermo-cautery and then after waiting some ten minutes 

 for the appearance of a secondary bleeding from vessels 

 previously unobserved, the wound may be closed. 



In tractable horses the suturing may be done in the stand- 

 ing position to excellent advantage, an hour or even more 

 after the ablation has been completed. The bleeding has 

 then ceased and the accumulation of a clot in the cavity is pre- 

 vented. 



Fourth Step. — Suturing. — The flaps are drawn together 

 by two sets of sutures.— a set of mattress sutures about 

 three-quarters of an inch from the edges and continuous 

 sutures to complete a perfect approximation. At the lower 

 end a drainage orifice is provided and is packed with gauze. 



Fifth Step. — Dressing. — The sutures are treated with a 

 dusting of iodoform and then covered with collodion. 



