The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
Step 2. A piece of gutta-percha is prepared 2½ inches wide and long
enough to reach from one angle of the jaw to the other when passing
in front of the chin. This is softened thoroughly by immersion in
boiling water, and when quite pliable should be quickly removed
from the hot and plunged for a moment into cold water: if a towel be
previously laid in the hot basin, the gutta-percha can be lifted on
it without stretching. It should be laid on a table, and its surface
sponged with cold water to prevent it sticking to the skin, it is
then slit from each end into tails 1 inch and 1½ inch wide, leaving
2 inches uncut at the centre. So prepared, the splint is applied to
the jaw with the middle pressing against the chin, the narrower ends
being carried horizontally backwards to the angles of the jaw; the
broader part is next bent up beneath the chin, its ends overlapping
the horizontal ones. While the splint is still soft, the surgeon
presses it firmly upwards that the gutta-percha may mould itself
accurately to the chin. When set, the splint is removed, trimmed,
and punched with holes here and there for evaporation. A covering of
wash-leather may be added, if desired. When the splint is finished,
it is replaced on the chin. If sole leather or pasteboard be used
instead of gutta-percha, they must be prepared in the same way, but
allowed to remain on the chin twenty-four hours that they may set
before the final trimming and adjustment.
Step 3. A bandage, 4 inches wide and 1½ yard long, and slit from each
end to about 2 inches from the centre, is then applied to the splint,
and a small pad of folded flannel should be placed at the nape of
the neck to protect the skin from the crossed bandage. When all is
ready, the two upper ends are carried behind the neck, crossed,
drawn tight, and tied or pinned on the forehead; the lower ends are
carried upwards, taking a turn round the first pair at the temples,
and fastened at the vertex (see fig. 23).
[Illustration: Fig. 23.—Outside splint for fracture of the lower jaw.]
The ligatures that may have been used on the teeth can now be
removed, or if they cause no pain, they may be left for a week or two.
It is a useful precaution to place a piece of soap plaster spread on
soft leather, under the chin and along the throat, to protect the
skin from the chafing of the splint while it is worn.
Sometimes the jaws close too nearly to allow food to be taken
between them. It is then necessary to place a thin wedge of softened
gutta-percha, 1½ inch long, ½ inch wide, and about ⅓ inch thick,
between the molars on each side. The gutta-percha must not be
softened much, or when the bite is taken the teeth will pass through
it. These plugs should be omitted unless absolutely required, as the
fragments keep a better position without them.
Public-domain text, read in full here on John Shaqi.
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