TREATMENT. OP WOUNDS 109 



:we are not justified in depending entirely upon our 

 mechanical disinfection to; prevent tetanus. 



Wounds That Cannot Be Drained by Gravitation of 

 the Discharges — Open Wounds 



This group -jfepelrndfiS-both the surgical alnd the acciden- 

 tal wounds located at the summit of a region. The trau- 

 matic cavity points upward and its bottom is too far 

 from the surface of the body to drain downward. It 

 includes the surgical wound of radical poll-evil opera- 

 tions and some operations for fistula of the withers, quit- 

 tors, and all the accidental wounds of the back, loins, 

 croup, and ie&ls. Almost all other wounds besides these 

 can be drained and treated by the method previously 

 described. The surgical wounds of this kind are often 

 invasions of badly infected, places, but the aim of the 

 operation in each case is to remove en masse the ihicrobe- 

 laden structures. ,,' . . 



Thus in poll evil, although we start with a badly 

 infected mass of tissue:aind tracts carjpeted with; infected 

 granulations, when the operation is properly' done all of 

 these are safely removed aad the cavity resillting, if not 

 entirely sterile, is in a::ifairIy'good state, for the easy 

 destruction of the infeeiiohi that remains. ^:uThe same 

 may be said of all operations of this character. ' The 

 operation itself is the mechanical disinfection needed to 

 ■promote healing, and the performance of the operations 

 must be carried out with this-end in view, for if we leave 

 our surgical wounds, ' made inJ infected structures, Mth- 

 out disposing of the brigih'ai'iinfeetion, or deposit more 

 in operating, these wounds.wiir'be difiicult to manage. 

 They will heal slowly. The fact ■ that we are operating , 

 upon infected structures is never an excuse for unclean 

 surgery. These operations should be as clean as those 



