The dressings are continued, as begun, if there be no indication for interference, although the granulations may be stimulated if too inactive. Gently irritating the granular surface with a 1-3,000 sublimate solution, although rarely permitted by most surgeons, does no harm; in fact, it is to be recommended before reapplying the dry dressing. In removing the dressings the edges of the flap will be found to adhere to the gauze; this may be gently lifted with the tenaculum, after previous softening with a weak solution of hydrogen peroxid. Pus (laudable) is the natural secretion from these flaps. Whatever remains on the surface is easily removed by an antiseptic solution, whereupon the powder is again dusted upon the part. When the flap has thickened sufficiently it may be covered by skin grafts, but this is rarely done until it has been properly implanted into the area for which it was intended and only then when union between its sutured borders has taken place. Ofttimes one part of a flap is left unattached, as, for instance, the outer border of the ear, with the object of developing a greater thickness. This must be cauterized along the edge with the caustic pencil, keeping the granulations within the desired limit until the opposite layer of skin has either cicatrized with it or has been grafted near it for the same purpose. The surface is then antiseptically treated, as any granulating surface, except as otherwise indicated. =Foreign Bodies.=—Especial care must be exercised with wounds into which foreign bodies have been implanted. Under favorable conditions many are kindly received by the tissues, but often these rebel and even with the greatest of care in dressing such wounds will often result in the necessity for removal of the substance. Individual cases of such nature are fully referred to later. CHAPTER VI SECONDARY ANTISEPSIS SEPTICEMIA FOLLOWING WOUND INFECTION =Symptoms.=—After operations performed under the most thorough aseptic or antiseptic procedure, wound fever, more or less marked, may be expected. It develops a few hours after operation and subsides in twenty-four or forty-eight hours. If, however, the wound has not been properly rendered aseptic, or in which there is reason for irritation or tension, more serious symptoms may develop about the second or third day. These symptoms increase with the amount of infection in the wound and result in septicemia, or septic intoxication, the outcome of the absorption of ptomains—the product of tissue decomposition. Inflammatory fever is marked by a sudden rise in temperature, 100° to 103° F., with a full, strong, and rapid pulse, headache, anorexia, coated tongue, constipation and diminished secretion. If the infection is severe delirium comes on.