24 Surgical Diseases and Surgery of the Dog 



been variously classified, but ior our purpose the following is the 

 best and simplest division: (i) By first or primary intention, and 

 (2) by secondary intention i. e., through formation of granulating 

 tissue either (a) without suppuration, or (b) with suppuration. 

 What is termed healing by direct union, as may apparently take place 

 between two wounded peritoneal surfaces during intra-abdominal 

 operations, has no existence in fact, but is in reality healing by first 

 intention, as a certain amount of serum is thrown out indistinguish- 

 able from the inflammatory condition, and it is the organization of 

 this serum through fibrin which binds together. Healing by first 

 intention is always aseptic, and theoretically, it should be the aim of 

 the practitioner to ensure its sequence to surgical operations, but 

 owing to the conditions under which our patients have their being, 

 it is rarely possible to attain this desirable result. Hence, in the 

 majority of cases, healing of surgical wounds in the dog takes place 

 by secondary intention either without or with suppuration, but most 

 often with suppuration. This, however, is a matter of little moment, 

 provided adequate drainage is afforded. Adventitious wounds in- 

 variably heal with suppuration. 



Treatment. The treatment of wounds comprises arrest of 

 hemorrhage, removal of foreign bodies, drainage, and coaptation of 

 edges. Hemorrhage from the larger vessels is controlled by liga- 

 ture, preferably with silk, a tourniquet being employed in the mean- 

 time if deemed advisable ; bleeding from capillaries is controlled by 

 hot water or compression. To secure the best possible conditions for 

 healing it is important that all oozing be completely checked. While 

 experiment shows that blood-clot contains a large amount of bacteri- 

 cidal substance it is known that the pyococcus aureus is very resistant 

 to the latter, and if present renders a clot putrescible and conducive 

 to suppuration. In case of considerable hemorrhage large quantities 

 of hot saline solution (5:1000 — 1:100) should be injected into the 

 bowel or hypodermically. Foreign bodies must be extracted with 

 forceps, and if necessary, their point of entrance enlarged. Usually, 

 it is best to clip away the hair from the immediate vicinity of a 

 wound. Antiseptic irrigation should be avoided, particularly in 

 recent wounds, as all antiseptics tend to irritate the tissues more or 

 less. A single exception is hydrogen dioxide, which may be used 

 for the purpose of breaking up and removing septic material. It is 

 better to cleanse with a stream of warm sterilized water directed 



