File:Railway surgery - a handbook on the management of injuries (1899) (14572785180).jpg

Identifier: railwaysurgeryha00herr (find matches)
Title: Railway surgery : a handbook on the management of injuries
Year: 1899 (1890s)
Authors: Herrick, Clinton B. (Clinton Bradford), b. 1859
Subjects: Railroad accidents Surgery Emergencies Railroads Wounds and Injuries
Publisher: New York : W. Wood and company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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in cases in which a distal part of an extremity has beeninjured beyond a reasonable possibility of saving it, havingconcluded that a primary amputation, or one done withinsix to ten hours of the receipt of such injury, is the betterone to do; and having learned that the nature of the case,coupled with the existing conditions, leads to the line ofamputation, it only remains to consider the method of do-ing such operation, and adopt the best one in treating theinjury. As before noted, it is necessary to have some fixed idearelative to the handling of this matter, and then by modi- 178 RAILWAY SURGERY. fication appropriately adjust it to each and every case com-ing to tis; for we will find, especially in one class of theserailway injuries, the necessity for so doing. First and always in any contemplated amputation an an-aesthetic must be given, and usually it is better to do sobefore beginning to clean up the parts, as this then can bemore thoroughly accomplished. We have advised before
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PIG. 72.—Showing the Proper Method of Applying an Esmarch Bandage previous to an Amputation. to use the anaesthetic one is accustomed to use; and itis unnecessary to reiterate the particular care with whichthe cleansing process should be carried out, by shaving,soaping, scrubbing, and disinfecting in and around the en-tire region where the injury and proposed operation islocated. An Esmarch bandage should be applied, if notalready on, and should be placed high enough to giveplenty of room for the proposed field of work. The proper application of this bandage is to be noted(see Fig. 72). Pass several turns of a three-inch rubber THE HOW TO AMPUTATE. 179 bandage tightly around the extremity, and do not per-mit the bandage you use to roll up or fold, into a narrowcord, which is liable to make so sharp a compressionupon the vessels as to injure their coats, and possibly cutthem off permanently. After protecting all the neighboring parts by clean orsterilized coverings, the question of f

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