_Drainage._--In wounds in which no cavity has been left, and in which there is no reason to suspect infection, drainage is unnecessary. When, however, the deeper parts of an extensive wound cannot be brought into accurate apposition, and especially when there is any prospect of oozing of blood or serum--as in amputation stumps or after excision of the breast--drainage is indicated. It is a wise precaution also to insert drainage tubes into wounds in fat patients when there is the slightest reason to suspect the presence of infection. Glass or rubber tubes are the best drains; but where it is desirable to leave little mark, a few strands of horse-hair, or a small roll of rubber, form a satisfactory substitute. Except when infection occurs, the drain is removed in from one to four days and the opening closed with a Michel's clip or a suture. #Punctured Wounds.#--Punctured wounds are produced by narrow, pointed instruments, and the sharper and smoother the instrument the more does the resulting injury resemble an incised wound; while from more rounded and rougher instruments the edges of the wound are more or less contused or lacerated. The depth of punctured wounds greatly exceeds their width, and the damage to subcutaneous parts is usually greater than that to the skin. When the instrument transfixes a part, the edges of the wound of entrance may be inverted, and those of the exit wound everted. If the instrument is a rough one, these conditions may be reversed by its sudden withdrawal. Punctured wounds neither gape nor bleed much. Even when a large vessel is implicated, the bleeding usually takes place into the tissues rather than externally. The _risks_ incident to this class of wounds are: (1) the extreme difficulty, especially when a dense fascia has been perforated, of rendering them aseptic, on account of the uncertainty as to their depth, and of the way in which the surface wound closes on the withdrawal of the instrument; (2) different forms of aneurysm may result from the puncture of a large vessel; (3) perforation of a joint, or of a serous cavity, such as the abdomen, thorax, or skull, materially adds to the danger. _Treatment._--The first indication is to purify the whole extent of the wound, and to remove any foreign body or blood-clot that may be in it. It is usually necessary to enlarge the wound, freely dividing injured fasciæ, paring away bruised tissues, and purifying the whole wound-surface. Any blood vessel that is punctured should be cut across and tied; and divided muscles, tendons, or nerves must be sutured. After hæmorrhage has been arrested, iodoform and bismuth paste is rubbed into the raw surface, and the wound closed. If there is any reason to doubt the asepticity of the wound, it is better treated by the open method, and a Bier's bandage should be applied.