skin and mucous membrane by
numerous catgut sutures, then painting the surface with Friar's balsam
and covering it over with two or three layers of cotton wadding, on
which the balsam is poured. The glans penis was left sufficiently free
to allow of water passing. The band or ring of dressing should be at
least one inch broad. The dressing was not suitable for young infants
who were frequently wetting. In the case of older children, they might
be allowed to go about on the second or third day, when the dressing
would be quite dry, and would not be required to be changed or renewed."
(Braithwaite's _Retrospect_, January, 1888.)
Any constricting or immovable and inelastic dressing is subject to the
same objections as plaster-of-Paris dressings in thigh-fractures,--that
of being dangerous and not expedient, unless the patient is constantly
under your eye.
Dr. Neil Macleod, in the _Edinburgh Medical Journal_ for March, 1883,
advises a procedure that has always looked favorably to me, and which I
once put in practice through the means of the ordinary ptosis
fenestrated forceps, in place of the ordinary circumcision forceps, the
sutures being introduced through the fenestra and the prepuce cut off on
the outer side of the forceps, the thickness of the steel arm on the
outer side of the fenestra allowing of the properly-sized border for the
hold of the sutures. Dr. Macleod places his sutures all in position
before making any incisions,--a procedure which will be found to save
the patient considerable pain; as with many the seizing and holding of
the edges of the skin and mucous membrane and the forcible pressure
exerted by the fingers or forceps while the needle is being forced
through is the most painful part of the operation. In doing this, care
must be taken to allow sufficient length to each thread to make two
sutures, as well as care must be taken to properly pull out the thread
in the centre between the four folds of tissue and to cut it
equidistant, after the ablation of the prepuce, a blunt hook being used
to fish up the threads from the preputial opening.
Erichsen favors the Jewish operation in young children, as being the
easiest and safest of performance. Slitting, or the inferior or superior
incision, he thought, left too much of the prepuce, which, wherever
there is a tendency to phimosis, should be entirely removed, "with a
view of preserving the health and cleanliness of the parts in after
life." In the p
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