436 VETERINARY SURGICAL OPERATIONS 



AFTER-CARE.— The patient is made to suffer the dis- 

 comfort of remaining in the standing position for at least 

 twenty days, and under no circumstance must this feature of 

 the after-care be omitted or neglectfully performed. Lying 

 down, even for a moment, will eliminate all chances of suc- 

 cess. To relieve the patient from fatigue as well as to assure 

 against accidental decumbency slings, after the first week 

 has past, are an excellent safeguard. The mattress sutures 

 are removed on the sixth to the seventh day and the con- 

 tinuous sutures some days later. If at the time of their re- 

 moval the union seems frail or imperfect at any part the 

 breach is mended with well adjusted interrupted sutures. 



The drainage orifice is kept open by daily renewals of 

 the gauze packing and by moderate injections of hydrogen 

 peroxide. 



SEQUELS AND ACCIDENTS.— I. Shock is a com- 

 mon sequel of operations upon very large shoe-boils, per- 

 formed without anaesthesia. The loss of blood and the pain 

 of a long, tedious dissection is a trying ordeal to which even 

 the most vigorous animal may succumb. The prevention 

 lies in the administration of chloroform and in rational 

 hsemostasis, during as well as after, completion of the dis- 

 section. 



2. Failure of the flaps to unite is the chief misfortune, 

 since the wound must then undergo a slow process of 

 cicatrization as an open wound that often ends in the forma- 

 tion of a new growth quite as large and always much more 

 unsightly than the original one. The cause of this accident 

 may be sepsis, inadequate drainage, stitch suppuration, 

 decumbency, or unusual movements of the leg from walk- 

 ing, fighting at flies, etc. With these causes provided 

 against, union always occurs at the proper time and the 

 internal cicatrization is practically complete at the end of 

 twenty days. 



The treatment of this accident consists of re-suturing 

 the edges after having trimmed off the granulations they now 

 contain. In the restive horse that seems destined to move 

 despite all usual means of prevention, a leg brace that will 

 immobilize the carpus, by thus limiting the elbow flexion, 

 is often helpful. When re-union is found impossible on ac- 

 count of the swollen condition of the flaps, open wound 

 treatment is the only recourse. The wound is then treated 

 frequently with strong astringent washes (zinc sulphate ten 

 per cent.) and the standing position maintained until cicatri- 

 zation has well advanced. 



