A System of Practical Surgery, Vol. 3: Surgery of the Extremities (Classic Reprint) - Brossura

Bergmann, Ernst Von

 
9780282850463: A System of Practical Surgery, Vol. 3: Surgery of the Extremities (Classic Reprint)

Sinossi

Excerpt from A System of Practical Surgery, Vol. 3: Surgery of the Extremities

The general principles which are standard for wounds of the arteries are given in Vol. II. It has been repeatedly recommended to ligate the subclavian above the clavicle previous to ligation at the site of injury, as the latter is often difficult by reason of the extravasation of blood, or at least to pass a ligature around the vessel to be tied in case of necessity, as digital compression in the supraclavicular notch has often proved uncertain, particularly if hindered by thick cushions of fat, enlarged glands, or extravasation of blood. It is better still to make the entire trunk accessible by a longitudinal incision, temporary resee tion of the clavicle, and separation of the fibres of the pectoralis major, as employed by Langenbeck and recently very generally approved. If the injury involves one of the branches, ligation of the trunk should be avoided if possible. In a case of avulsion of a branch (dislocation) Korte recently attempted lateral suture of the vessel. It held twenty one days, but ligation of the axillary was necessitated by secondary hemorrhage.

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