Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
shallow, bluish, pigmented dirty, sloughing,
inflamed, often granulations, deep, often
grayish yellow. sluggish, greenish in color.
usually superficial.
_Edges_:
not elevated or undermined or punched out thin
thickened. thickened space, and undermined
very irregular. shape, round or
serpiginous.
_Surrounding area_:
red and inflamed. pigmented, varicose dusky red, scars
veins, often of old syphilitic
edema and eczema. ulcers.
_Healing_:
rapid under support of veins, mercury and
antiseptic operate and remove iodides necessary,
treatment. veins. salvarsan
or neosalvarsan.
+Treatment.+ The treatment of varicose ulcers must be based on
antiseptic cleanliness, and the improvement of nutrition by
improvement of the circulation of the blood and lymph. Then again the
treatment will vary according to the time when the ulcer is first seen
by the surgeon. In aggravated ulcers, especially those accompanied by
crusts, foul smelling discharges and various inflammatory conditions,
the leg should be washed once or twice daily with soap and water,
cleansed with a piece of sterile gauze, and shaved when necessary.
Warm applications should be employed such as Wright’s solution, boric
acid; Thiersch and the stronger antiseptics are uncalled for, as they
often induce eczema. Under such treatment, in most cases, the swelling
and irritation will subside and the ulcer will become clean and more
healthy in appearance, especially if the patient be confined to bed
with elevation of the limb. Rest always seems to the patient a useless
waste of time, but in reality time is thus saved. It is by far the
most important point in the treatment of ulcers of the leg in which
poor circulation is a factor, but the plan must be carried out
consistently in order to obtain the best results. The condition does
not admit of occasionally walking about the house or of sitting in a
chair. However, when circumstances do not permit of the recumbent
position, the veins can be supported in various ways. Bandages of
plain rubber, or rubber cloth, or cloth woven and rendered elastic by
the character of mesh, or elastic stockings, or flannel, gauze, or
muslin bandages, can be used. It is preferable to use flannel bandage
(see Therapeutic measures) for the reasons mentioned. The best means
of obtaining the support, however, is by the use of Unna’s Paste. The
technic and application of this method of treatment has also been
described (Therapeutic measures).
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