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The retro-pharyngeal glands lie on each side of the median line upon the rectus capitis anticus major muscle and in front of the pre-vertebral layer of the cervical fascia. When they are infected with pyogenic organisms or with tubercle bacilli, they may lead to the formation of one form of retro-pharyngeal abscess.
In aseptic wounds the tube may be removed in from twenty-four to forty-eight hours, and where it is important to avoid a scar, the opening should be closed with a Michel's clip; in infected wounds the tube must remain as long as the discharge continues. The fascia and skin should be brought into accurate apposition by sutures.
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.
It may be advisable to displace the liberated nerve from its original position so as to minimise the risk of its incorporation in the scar of the original wound or in that resulting from the operation for example, the radial nerve may be buried in the substance of the triceps, or it may be surrounded by a segment of vein or portion of fat-bearing fascia.
To extirpate the disease it is necessary to excise the tumour, with a zone of healthy skin around it and a somewhat large zone of the underlying subcutaneous tissue and deep fascia. Hogarth Pringle recommends that a broad strip of subcutaneous fascia up to and including the nearest anatomical group of glands should be removed with the tumour in one continuous piece.
The mantel at Number 312 Cypress Street, with its well-proportioned entablature and paneled pilasters, displays a central panel in the frieze similar to the foregoing examples, but possesses a more distinct Adam character in the human figures in composition applied to the pilaster projections of the frieze, and in the drillings of the upper fascia of the architrave, simulating festoons.
An incision is made through the skin and fascia, a grooved director is gently pushed through the deeper tissues till pus escapes along its groove, and then the track is widened by passing in a pair of dressing forceps and expanding the blades. A tube, or strip of rubber tissue, is introduced, and the subsequent treatment carried out as in other abscesses.
Primary union of the small surgical wound of the skin and fascia occurs in forty-eight hours. The reader is referred to William's "Veterinary Surgical and Obstetrical Operations," for a complete description of this operation. This affection is briefly described by Cadiot but no complete treatise on this condition has been published.
The pus infiltrates the meshes of the cellular tissue, there is sloughing of considerable portions of tissue of low vitality, such as fat, fascia, or tendon, and if the process continues for some time several collections of pus may form.
These pouches vary in size from a bean to a hen's egg, the larger forms being called venous cysts, and being most commonly met with in the region of the saphenous opening and of the opening in the popliteal fascia. [Illustration: FIG.
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