The Principles and practice of surgery

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W. Wood & Company, 1872 - 943 Seiten
 

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Seite 372 - ... femoral artery, just below Poupart's ligament, before commencing the -amputation, as recommended by Valentine Mott, Delpech, Blandin, and others. Larrey advised to tie both the artery and vein ; or it might be proper to apply to one or both of these vessels a ligature of reserve, which could be removed when the operation was completed. The instructions given by Fergusson, and others, to introduce the point of the knife "about midway between the trochanter major and the anterior superior spinous...
Seite 617 - Figs. 314 and 315 is passed through the fissure, so that its point can be laid on the tissues immediately above the soft velum, midway between its attachment to the bones and the posterior margin, and about half-way between the velum and the lower end of the Eustachian tube ; the point is then thrust deep, and carried half an inch or more backwards and forwards so as to cut the levator palati across in the line indicated by letter a in drawing (fig.
Seite 47 - By this means, I hope, gentlemen, not only to supply an amount of skin equal to the size of the piece transferred, but to furnish, also, a nucleus from which additional skin shall be formed. I hope to establish a new centre of life — an oasis — from whose outer verge a true a'nd healthy vegetation shall advance in every direction over the exhausted soil.
Seite 182 - Some of the instruments have been made with stops, to indicate when a proper invagination was reached; but by further experience it was found that the touch was the best guide for the operator. By a continued traction upon the external coat of an artery, after the invagination is once commenced, the internal and middle coats may be peeled up and pushed entirely out of the external coat, and this latter coat be drawn out through the...
Seite 47 - In consequence of one or of both of these two latter circumstances, it will not be necessary to make the graft so large as the deficiency it is intended to supply.
Seite 47 - The graft must be brought from a part quite remote; generally from an opposite limb, or from another person. 4th. — If smaller than the chasm which it is intended to fill, the graft will grow or project from itself new skin to supply the deficiency.
Seite 336 - ... amputation in a great majority of cases ; and certainly, assuming the premises to be correct, the argument seems not unsound. Says McLeod, " If this precious moment could be seized at all times, and that operation performed under chloroform, which assists so much in warding off the ' ébranlement' we fear, how much more successful would our results prove than under other circumstances they can ever be.
Seite 47 - Summary: — 1st — Ulcers, accompanied with extensive loss of integument, do generally refuse to heal, whatever may be the health of the body or of the limb. 2d. — Anaplasty will sometimes succeed in accomplishing a permanent cure, and especially where the health of the body and of the limb are perfect, and where, by inference, the refusal to heal is alone attributable to the extent of the ttgumentary loss.
Seite 48 - ... new skin to supply the deficiency. 5th. — It is not improbable that the graft will expand during the process of cicatrization at its margins, but especially for a time after the cicatrization is consummated.
Seite 46 - ... the Dr. has proposed to the boy a plastic operation, with the view of planting upon the centre of the ulcer a piece of new and perfectly healthy skin He proposes to take this from the calf of the other leg (having secured the two together,) not intending to cover the whole sore, but perhaps two or three square inches, which he believes will be enough to secure the closure of the whole wound in a short time.

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