The Cure of Rupture by Paraffin InjectionsMiller, Charles Conrad
Philosophy
The Cure of Rupture by Paraffin Injections
Miller, Charles Conrad
Hernia; Paraffin injections
The tendency is to overinject a case. One must not forget that the
tissues will probably thicken to twice the size of the mass injected.
The operator must estimate as nearly as possible the size of the tract
to be filled and then aim to throw in enough to about half fill it.
The diffusion of the paraffin will usually safely hold the hernia when
the patient rises from the table.
Should the operator throw in mixtures one and two until the parts are
fairly distended and the hernia be not held it is better to use only
the plain sterile vaseline for a subsequent injection at the site of
the internal ring. If a half dram of vaseline at this point does not
hold the hernia a small amount of vaseline may then be thrown in the
central portion of the canal.
At first the vaseline injections should be used whenever in doubt as
to the amount needed above a certain point. As the operator becomes
acquainted with the needs of cases by experience the vaseline can be
largely substituted by the paraffin mixture number one.
TECHNIC TO BE USED IN INJECTING INGUINAL HERNIA.
Have a syringe loaded with paraffin mixture number one and another
loaded with sterile vaseline. See that the paraffin flows smoothly
from the syringe without leaks. See also that the vaseline syringe is
working smoothly.
Have needles intended for injection of paraffin free from this agent.
Place patient on back, thighs flexed slightly or straight if the
external ring is easily accessible. Follow the spermatic cord and
locate definitely the external ring.
Attach empty syringe to needle. Pass needle point through skin. As
soon as needle point is through skin exhaust syringe. That is draw
piston out to form vacuum in syringe and obtain suction. Pass the
needle slowly through external ring and along close to the roof of
inguinal canal.
When needle is in full length, if no vein has been struck and blood
aspirated into the syringe, detach syringe and screw the paraffin
syringe tightly to needle.
Inject a few drops of paraffin by screwing down syringe. As paraffin
is flowing move the point of the needle about in the loose cellular
tissue and continuing the injection slowly withdraw the needle.
Continue moving the point of the needle in all directions as the
needle is withdrawn so that the paraffin will be diffused as much as
possible. As the point of the needle emerges between the pillars of
the external ring discontinue the injection.
Test the effectiveness of the injection.
Allow patient to stand on feet. If the hernia reappears have the
patient lie down again and reinsert the needle as before described and
inject sterile vaseline rather than the paraffin mixture.
Not more than enough paraffin to half fill the canal should be
injected. If such quantity does not hold hernia sterile vaseline
should be used discreetly until hernia is held.
The surgeon must estimate the approximate size of the inguinal canal
by the size of the external ring.
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