Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
The curative or operative treatment of varicose veins consists of
performing a resection of the internal saphenous vein of one or two
inches, near the saphenous opening into the femoral. This is known as
the _Trendelenburg_ method. About 90 per cent of all cases can be
cured by this method. The operation can be performed under local
anesthesia and presents no difficulties.
Another procedure is known as _Schede’s_ method. This consists of
making a circular incision around the leg just below the knee joint,
and in tying all the superficial veins thus exposed.
_Mayo’s_ operation consists of the total extirpation of the internal
saphenous vein from the saphenous opening to the internal malleolus. A
small incision is made high up, and at a distance of from 8 to 10
inches, a second incision is made, and in this manner the entire vein
is removed by making several incisions.
The patient should remain in bed about three weeks following an
operation of this kind and afterwards an elastic stocking, or an ideal
bandage, should be worn for a considerable time.
+Phlebitis+, or inflammation of a vein, may be plastic or purulent in
nature. Plastic phlebitis, while occasionally due to gout, or to some
other constitutional condition, usually arises from a wound or other
injury, from the extension to the vein of a perivascular inflammation,
or, in the portal region, from an embolus.
Varicose veins are particularly liable to phlebitis. When phlebitis
begins, a thrombus forms because of the destruction of the endothelial
coat, and this clot may be absorbed or organized.
+Suppurative Phlebitis+ is a suppurative inflammation of the vein,
arising by infection from suppurating perivascular tissues (_infective
thrombophlebitis_). It is most frequently met with in cellulitis or
phlegmonous erysipelas, but there are a great many other causes.
A thrombus forms, the vein wall suppurates, is softened and in part
destroyed, and the clot becomes purulent. No bleeding occurs when the
vein ruptures, as a barrier of clot keeps back the blood stream. The
clot of suppurative phlebitis cannot be absorbed and cannot organize.
Septic phlebitis causes pyemia, and the infected clots of pyemia cause
phlebitis. The symptoms of phlebitis are pain, which is at once felt
in the limb along the track of the inflamed vein, and tenderness along
the same area; the overlying skin is red, hot, and tender, and the
lymphatic nodes in the groin swell; there is marked edema, but the
inflamed venous cords can be readily felt. The constitutional
disturbance is marked; rigors and high temperature, 103°F. to 105°F.
(remittent type), are followed by profuse sweats. The general
condition, facies and anxiety, dry and parched tongue, delirium and
general distress, at once directs attention to the infectious nature
of the trouble. The leucocyte count will show a marked increase in the
number of polynuclears.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account