[p. 194] be smaller, but rather
greater than those formerly described. When applied, the patient should
have the feeling of the parts being properly secured, but not too
tight, and in particular he should be able to say that they are firm
about the wound. And the intervals of time during which the parts
seem to be properly adjusted, and those in which they get loose, should
be the same as those formerly described. The bandages should be renewed
on the third day, and the after treatment conducted in the same manner
as formerly described, except that in the latter case the compression
should be somewhat less than in the former. And if matters go on properly,
the parts about the wound should be found at every dressing always
more and more free of swelling, and the swelling should have subsided
on the whole part comprehended by the bandages. And the suppurations
will take place more speedily than in the case of wounds treated otherwise;
and the pieces of flesh in the wound which have become black and dead,
will sooner separate and fall off under this plan of treatment than
any other, and the sore will come more quickly to cicatrization when
thus treated than otherwise. The reason of all this is, that the parts
in which the wound is situated, and the surrounding parts, are kept
free of swelling. In all other respects the treatment is to be conducted
as in cases of fracture without a wound of the integuments. Splints
should not be applied. On this account the bandages should be more
numerous than in the former case, both because they must be put on
less tight, and because the splints are later of being applied. But
if you do apply the splints, they should not be applied along the
wound, and they are to be put on in a loose manner, especial care
being taken that there may be no great compression from the splints.
This direction has been formerly given. And the diet should be more
restricted, and for a longer period, in those cases in which there
is a wound at the commencement, and when the bones protrude through
the skin; and, in a word, the greater the wound, the more severe and
protracted should the regimen be.
Part 27
The treatment of the sores is the same in those cases of fracture
in which there was no wound of the skin at first, but
|