Page 137 - My FlipBook

INFLAMMATION. 135
parts by 'the formation of gangrenous patches. Superficial in-
cisions will relieve the tension of the skin and mucous mem-
brane, and also evacuate the pus of an abscess when it is near the
surface.
Deeper incisions are necessary when the pus is at a greater
distance from the surface, and there is considerable tension. In-
cisions are also often judicious as a prevention of suppuration
and ulceration ; also in cases where the presence of pus is sus-
pected, but there is no apparent fluctuation. In making deep
incisions, care is necessary to avoid wounding arteries and
nerves; hence the director should precede the use of the knife.
In acute abscesses the incisions should be made at an early stage,
and of such a size as will permit of the free evacuation of the
pus, and in the most depending position, to insure its easy dis-
charge. Hence, as soon as fluctuation is detected in an acute
abscess, the incision for the escape of the pus should be made
;
while in the case of a chronic or cold abscess, the incision may
be delayed, or a puncture with a trocar substituted for it, which
may at once be closed.
Drainage {or Irrigation) is employed for the purpose of giving
outlet for any matters liable to collect in a wound or abscess
which may act as obstacles to the process of repair. Teeth af-
fected with abscess are often relieved and retained by an opening
made into the pulp canal or into the abscess sac, sufficiently free
to relieve the tension and drain off the accumulated pus ; also in
the case of abscess of the antrum, where an opening made
through the alveolar cavity of one of the roots of a posterior tooth
is kept open by means of a canula, to relieve the tension and
permit the pus to escape as it accumulates, and also to afford an
easy entrance for the injection of antiseptic and stimulating agents
in the treatment of such cases. Drainage can also be made
through soft tissues, such as the gum, etc., by strands of floss
silk, hemp thread, and horse hair, dipped in a carbolic acid solu-
tion before they are inserted into the opening connected with the
sac ; also by means of caoutchouc tubing.
Counter Irritation^ "counter irritants," or "derivatives," are
also employed in the treatment of inflammation, for the purpose