PUNCTURED WOUNDS OF THE THORAX 493 



i. Penetrant Wounds. 



TREATMENT. — In soiipeds the free admission of air 

 into the thorax at once provokes a distressing dyspnoea that 

 reflects over the whole organism and materially mitigates 

 against recovery from the wound itself. Inflammation of 

 the pleura and lungs is also difficult to prevent or control. 

 In bovines and canines a unilateral chest wound is much less 

 serious because the supervening phenomena are more prone 

 to remain unilateral. As there is no communication be- 

 tween the two pleural sacs in these species, the inflamma- 

 tion is less inclined to invade the opposite side, but the favor- 

 ing element is the possibility of maintaining drainage with- 

 out producing the distressing bilateral pneumothorax that 

 always accompanies the application of drainage tubes in the 

 thorax of horses, whose pleural sacs communicate with each 

 other. 



In the animals having non-communicating pleural sacs 

 the procedure consists of first submitting the environs of the 

 wound to a thorough shaving and cleansing, and the wound 

 itself to a mechanical and medicinal disinfection. The 

 ragged parts are trimmed and the whole channel treated to 

 a good soaking with tincture of iodine. Irrigations that 

 might wash infectious matter into the thoracic cavity are 

 avoided. The disinfection having been properly completed, 

 a perforated rubber drainage tube is placed into the tract 

 so that its inner extremity invades the thorax. The outer 

 end is then fixed to the skin with a stitch or two and the 

 wound closed tightly around it with interrupted sutures. A 

 coating of collodion to the sutures to protect against infec- 

 tion, and a tight body wrap of muslin to immobilize the cos- 

 tal movements as much as possible, complete the procedure. 



The after-care consists of probing into the tube to pre- 

 vent blocking up with dried secretions. At the end of eight 

 days the tube • is removed and the wound packed loosely 

 with gauze daily until closed. 



In soiipeds penetrant wounds, after being submitted to 

 a thorough disinfection, must be closed tightly with sutures 

 or else drained with an apparatus that will prevent the ad- 

 mission of air into the thorax with each inspiration. This 

 apparatus is constructed as follows : A flexible rubber hose 

 is attached to the end of the drainage tube and then dropped 

 into a quart bottle of water hung from a surcingle. The 

 wound secretions overflow the bottle, whose neck is unob- 

 structed by the small tube. 



