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Updated: June 24, 2025
In exceptional cases the skin is thinned and gives way, resulting in the formation of a sinus. Treatment. In the common flexor sheath of the palm, an attempt may be made to cure the condition by removing the contents through a small incision and filling the cavity with iodoform glycerine, followed by the use of Bier's bandage.
The treatment of diffuse cellulitis depends to a large extent on the situation and extent of the affected area, and on the stage of the process. In the limbs, for example, where the application of a constricting band is practicable, Bier's method of inducing passive hyperæmia yields excellent results.
Bier's Constricting Bandage. To induce a passive hyperæmia in a limb, an elastic bandage is applied some distance above the inflamed area sufficiently tightly to obstruct the venous return from the distal parts without arresting in any way the inflow of arterial blood (Fig.
The prophylaxis of these ulcers consists in excluding bacteria, by cleansing crushed or bruised parts, and applying sterilised dressings and properly adjusted splints. If there is reason to fear that the disinfection has not been complete, a Bier's constricting bandage should be applied for some hours each day.
Impaired movement of tendons and joints is, therefore, a common sequel to this variety of whitlow. The treatment consists in inducing passive hyperæmia by Bier's method, and, if this is done early, suppuration may be avoided. If pus forms, small incisions are made, under local anæsthesia, to relieve the tension in the sheath and to diminish the risk of the tendons sloughing.
In such conditions as compound fractures and severe lacerated wounds, much can be done to avert the conditions which lead to pyæmia, by applying a Bier's constricting bandage as soon as there is evidence of infection having taken place, or even if there is reason to suspect that the wound is not aseptic.
A priest sat on either side of the bier's head, and one of them read softly, so that I had not heard him at first. So I stood and looked in the face which was so calm, and then knelt and prayed there for a little time. When I rose I was aware for the first time that behind me knelt Erling, but he did not rise with me.
The local treatment consists in employing soothing applications and a Bier's bandage for two or three hours twice daily while the symptoms are acute; later, hot-air baths, massage, and exercises are indicated. It is remarkable how completely even the most deformed joints may recover their function. Dietetic and medicinal treatment must also be employed.
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