_Diet._—It is best to give no nourishment for the first three or four
hours, and but very sparingly for the first twenty-four. Iced milk and
water, or milk and soda-water, given in small spoonfuls, should be the
first food supplied; but after twenty four hours, when the tendency to
vomiting has disappeared, the food should be slightly warm. Milk and
water given by spoon or from a feeder at frequent intervals will form the
staple article of diet; but if the patient be rather older, strong broths
and clear soup may be added. By the fifth day they may often safely take
soaked bread, custard pudding or some soft farinaceous food; but no hard
substance, liable to damage the newly-formed adhesions, should be allowed
for fully a fortnight.
If the patient be sufficiently intelligent, it is advisable that the
_mouth_ should be gently _washed out_, especially after food, with a
tepid weak boracic solution. This is best effected by using it as an
ordinary gargle; syringing the mouth I consider to be unadvisable,
because the jet if forcible will tend to find its way between the margins
of the wound, and hinder union. Some surgeons recommend that prior to
fastening the stitches during the operation, the edges of the wound
should be touched with a solution of chloride of zinc in order to assist
in keeping them aseptic; this is really unnecessary if careful washing of
the mouth after the operation be enjoined.
Of course _absolute quiet_ is essential, and all attempts at talking
must be strictly forbidden. The child should be closely watched, and
any attempt to meddle with the palate should be prevented by tying down
the hands, which may be done as a matter of precaution throughout the
whole duration of the case with young children, and as a routine during
sleep with all patients. If the child is noticed to suck at the palate,
or curl the tongue up against it, an effort should be made to divert its
attention.
The palate should not be examined too often. The blanched appearance
observed at the close of the operation generally disappears during the
first few hours, and a moderately injected condition of the mucous
membrane with slight swelling of the palatal tissues is a sign that all
is doing well. The lateral incisions usually fill with granulations
rapidly, and these subsequently cicatrise; the rate of their healing
depends on the width of the aperture and on the vitality of the patient.
Public-domain text, read in full here on John Shaqi.
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