Free incision of abscess of ostitis of hip, and closure without drainage / by H. Augustus Wilson.

  • Wilson, H. Augustus (Harry Augustus), 1853-1919.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Free incision of abscess of ostitis of hip, and closure without drainage / by H. Augustus Wilson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    4/8 (page 4)
    shreds of fibrous tissue remaining are removed by scissors. It is now possible to trace the site of the original ostitis, and when found, if not too extensive, its removal is frequently easily accomplished with a gouge. The difficulty experienced in obtaining a sterile, and at the same time an efficient emulsion of iodoform in olive oil, has induced me to dust powdered iodoform over the entire surface after it has been care- fully dried with gauze sponges. The edges of the wound are brought in contact and so held by silkworm-gut sutures, and the entire surface is covered with a thick fold of aseptic gauze, the incision having been covered with protective. Enforced immobilization is secured with a long padded splint reaching from the axilla to the malleolus, and retained in position with plaster-of-Paris bandages applied to the leg and the trunk, or by some form of portable bed or fixation apparatus. At the expiration of one week to ten days the stitches are usually removed, if primary union has been obtained. The external dressings and fixation appa- ratus are readjusted and maintained for a period of three weeks more. The subsequent procedure is enforced mechanical immobiliza- tion of the joint, either in bed or by apparatus, as the individual requirements of the case may indicate. While the statistics I have to offer cover a comparatively small number of cases, they may be of use when added to others, and I therefore give them. The cases operated upon by me by the method described number twenty-four. There were 16 girls and 8 boys. Eighteen were upon the left side and six were upon the right. The abscesses had been observed by the patient, parent, or attending phy- sicians as follows: For three months in 5 cases; seven months in 3 cases; eight months in 4 cases; ten months in 6 cases; one year in 4 cases; two years in 2 cases. In 5 cases reaccumulation occurred, and subsequent evacuation was required. In 3 of these there has been no reaccumulation, although several months have elapsed. In 1 case a persistent sinus exists. In 1 case infection took place from a stitch-wound abscess, when catgut sutures were employed. In 14 cases more than one year had elapsed, and in 11 of this number the original cicatrices have remained firm and unbroken; 3 were reopened for reaccu- mulation, and the second cicatrices have not yielded six months after the second operations. In 10 cases, less than a year has elapsed since the operation, ot which number 9 have remained closed, and in 1 a persistent sinus is now present. In 16 cases the