A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
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A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
a certain amount of constriction of the skin may be expected from the
addition of the instrument employed in the extraction; but if much
resistance is offered to their passage out, it is better to divide the
edges of the fascia and skin to the amount of enlargement required
than to use force. In removing fragments of shells or detached pieces
of bone, the fascia and skin have almost invariably to be divided to a
considerable extent.
Where the finger is not sufficiently long to reach the bottom of the
wound, even when the soft parts have been approximated by pressure
from an opposite direction, and when the lodgment of a projectile is
suspected, a long silver probe, that admits of being bent by the hand
if required, is the best substitute. Elastic bougies or catheters are
apt to become curled among the soft parts, and do not convey to the
sense of touch the same amount of information as metallic instruments
do. The probe should be employed with great nicety and care, for it may
inflict injury on vessels or other structures which have escaped from
direct contact with the ball, but have returned, by their elasticity,
to the situations from which they had been pushed or drawn aside
during its passage. The above directions for examining wounds apply
more particularly to such as penetrate the extremities, or extend
superficially in other parts of the body; where a missile has entered
any of the important cavities, search for it is not to be made, but
the surgeon’s attention is to be directed to matters of more vital
importance to be hereafter noticed.
Public-domain text, read in full here on John Shaqi.
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