REPAIR OF WOUNDS ' 



By WILLIAM BRADY, M.D., Elmira, New York 



The general management of wounds should be based 

 on a practical' knowledge of the physiology and path- 

 ology of repair. With a thorough understanding of the 

 process of healing the young tyro may bring about the 

 cure of' old varicose or other ulcers which his senior col- 

 leagues have perhaps pronounced incurable after years 

 of empirical tinkering with various highly recommended 

 ointments. Without going into details, a brief considera- 

 tion of certain features of the healing process may be 

 of interest. 



In a wound not aseptic, inflammatory symptoms are 

 apt to appear on the second day. Every case should 

 therefore be seen at this time, whether the dressing is to 

 be disturbed or not. It is often wise to leave a strand 

 of silkworm or gauze in the lower angle of an acci- 

 dental wound of whose asepsis there is much doubt, 

 and to remove it on the second or third day if the 

 wound is, clean. The best dressing for such a case is the 

 wet normal salt gauze, which is undeniably superior to 

 dry gauze or ointments as a medium for drainage for 

 exuding serum. 



Sutures, if inserted, should be removed on the fifth day 

 if there is no tension upon the edges of the wound. If 

 tension is unavoidable, the sutures should remain until 

 about the tenth day. It is generally well to reinforce, 

 or even replace, suturing by adhesive strapping to relieve 

 undue tension. A wounded extremity is always more at 



iReprint from Medical Summary. 



131 



