materially diminishes.

In lacerated wounds of the anterior brachial region, after having
controlled hemorrhage, an area around the wound margin is freed of hair
by clipping or shaving. The wound is carefully examined, and the best
site for drainage is selected and a suitable opening for wound discharge
is provided for. Where the extensor carpiradialis (metacarpi magnus)
with other structures, is divided and the distal portion is torn
downward, as frequently is the case in barbed wire cuts, it is
necessary to make careful provision for drainage. The wound is
thoroughly cleansed by means of ablutions if necessary; but preferably
by swabbing with pledgets of cotton or gauze which are moistened in
antiseptic solutions. All shreds of macerated tissue are clipped with
scissors and finally the whole wound surface is painted with tincture of
iodin.

If drainage is made by cutting through the tissues in the median portion
of the structures that have been displaced, the opening should be packed
with gauze so that it may remain patent after swelling has occurred.
Such packing is left _in situ_ for twenty-four hours.

The pendant muscular portions of tissues are sutured up by means of
tapes and, while perfect apposition is not ordinarily possible, it is
very essential to train the pendant tissues in their normal position
even if they require resuturing within a week. This minimizes
granulation of tissue, and there results less scar if the detached
portions are kept near, even if not in contact with the proximal wound
margins. The skin together with subcutaneous fascia is sutured on either
side unless drainage is to be provided for on one side, and the
lowermost part of that side is left unsutured.

After-care.--Where extensive suturing of tissues has been necessary,
subjects must be kept quiet. They are best confined in box stalls and
not taken out for several weeks. Particularly is this true where
transverse division of extensors has taken place. Sutures are removed at
the end of from ten days to three weeks as cases permit. Drainage of
wound secretions, which usually become infected, is necessary, because
with obstructed drainage in an infected wound of this kind, there will
result an early destruction of tissue at some point sutured. Daily
irrigation done in a manner that practical asepsis is carried out, is
necessary for about a week. All irrigation is done by way of the
drainage opening, and this with warm aqueous soluti