faces must be brought into accurate apposition, care being taken that
no inversion of the cutaneous surface takes place. In extensive and deep
wounds, to ensure more complete closure and to prevent subsequent
stretching of the scar, it is advisable to unite the different
structures--muscles, fasciae, and subcutaneous tissue--by separate series
of _buried sutures_ of catgut or other absorbable material. For the
approximation of the skin edges, stitches of horse-hair, fishing-gut, or
fine silk are the most appropriate. These _stitches of coaptation_ may
be interrupted or continuous. In small superficial wounds on exposed
parts, stitch marks may be avoided by approximating the edges with
strips of gauze fixed in position by collodion, or by subcutaneous
sutures of fine catgut. Where the skin is loose, as, for example, in the
neck, on the limbs, or in the scrotum, the use of Michel's clips is
advantageous in so far as these bring the deep surfaces of the skin into
accurate apposition, are introduced with comparatively little pain, and
leave only a slight mark if removed within forty-eight hours.

When there is any difficulty in bringing the edges of the wound into
apposition, a few interrupted _relaxation stitches_ may be introduced
wide of the margins, to take the strain off the coaptation stitches.
Stout silk, fishing-gut, or silver wire may be employed for this
purpose. When the tension is extreme, Lister's button suture may be
employed. The tension is relieved and death of skin prevented by scoring
it freely with a sharp knife. Relaxation stitches should be removed in
four or five days, and stitches of coaptation in from seven to ten days.
On the face and neck, wounds heal rapidly, and stitches may be removed
in two or three days, thus diminishing the marks they leave.

_Drainage._--In wounds in which no cavity has been left, and in which
there is no reason to suspect infection, drainage is unnecessary. When,
however, the deeper parts of an extensive wound cannot be brought into
accurate apposition, and especially when there is any prospect of oozing
of blood or serum--as in amputation stumps or after excision of the
breast--drainage is indicated. It is a wise precaution also to insert
drainage tubes into wounds in fat patients when there is the slightest
reason to suspect the presence of infection. Glass or rubber tubes are
the best drains; but where it is desirable to leave little mark, a few
strands of horse-hair, or