The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson.

  • Watson, B. A. (Beriah André), 1836-1892.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    time when the performance of an amputation is attended with the minimum of danger. It is possible, however, that the highest degree of safety may be found after the forma- tion of the line of separation and the development of gran- ulations, which cover the extreme border of the lining tissue. The pathological changes involved in these processes are such as to thoroughly convince us that the increased safety in these conditions depends essentially on the formation of a barrier, which at first merely impedes, but finally arrests the absorption of septic material, and furthermore on the elimination by the natural emunctories of the poison which had already been absorbed. While it must be admitted that surgeons at all times prefer to operate on patients who are entirely free from septic infection, nevertheless there are circumstances under which the amputation of a limb should be performed without awaiting a more favorable period. The intelligent performance of this operation at such times re- quires that the surgeon should determine as accurately as possible, the degree of danger which may be justly expected to arise from the contemplated operative procedure. Many important points bearing on this subject have not yet been examined with sufficient care to enable us to understand their value in this connection. How far may we depend on the temperature in indicating the danger from septic ab- sorption under such circumstances ? Are there conditions under which the poison after its absorption may remain la- tent in the system ? No attempt will be made to answer these queries ; but it is rational to presume that in cases of traumatic gangrene the progress of the septic infection will in a measure depend on the rapidity with which the living- tissues lose their vitality, and the extent of the disease. Rapidly spreading gangrene does not allow nature time to raise the barriers which she employs to impede the progress of this contamination, and the more extensive the gangrenous action, the greater are the number of absorbents which take up and disseminate the poison. It may therefore be claimed that the danger in cases of operative procedure from septic infection, will generally bear a certain relation to these fac-