Contused and Lacerated Wounds.
THESE, are produced by cudgels, stones, bullets, or whatever else of a blunt nature tears asunder the muscular fibres, leaving jagged and uneven surfaces. They are rarely healed without suppuration, and are frequently followed by violent inflammation. They suppurate and slough, but they do not bleed much, not even, sometimes, when large arteries are torn asunder. Whole limbs are occasionally torn away without hemorrhage. In warm climates, lock jaw is a frequent consequence of them.
Treatment. Draw the edges of the wound loosely together, and retain them with a few strips of adhesive plaster. Sometimes a suture, here and there, will be proper. If a great deal of inflammation ensues, take away the adhesive plaster and the stitches, and apply a poultice, or water dressing; and if there be much fever, restlessness, or delirium, saline purgatives (18), (25), and opium (118), will be needed; but especially will it be necessary to again disinfect the wound, and by every means possible render the field aseptic.
The wound having thrown off its slough is, suppurated, become clean, and formed granulations, the poultices are to be taken off, and simple dressings substituted. These should be adapted to the conditions of the sore, according to the directions for treating ulcers.
When the wound is so severe that extensive mortification will be sure to follow, the limb must be immediately taken off, to save the life of the patient.
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