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Updated: June 28, 2025
#Treatment in relation to the Condition of the Ulcer.# Ulcers in a weak condition. If the weak condition of the ulcer is due to anæmia or kidney disease, these affections must first be treated. Locally, the imperfect granulations should be scraped away, and some stimulating agent applied to the raw surface to promote the growth of healthy granulations. For this purpose the sore may be covered with gauze smeared with a 6 to 8
Under proper treatment, however, or by a process of nature, these granulations cease to sprout; they begin to disappear; the ulcer diminishes; it heals; scarcely a trace of it can be seen; the cornea recovers its perfect transparency, and vision is not in the slightest degree impaired. There is a state of the orbit which requires some consideration.
The most common is an osteomyelitis commencing in the marrow exposed in a wound infected with pyogenic organisms. In amputation stumps, fungating granulations protrude from the sawn end of the bone, and if necrosis takes place, the sequestrum is annular, affecting the cross-section of the bone at the saw-line; or tubular, extending up the shaft, and tapering off above.
This may be thin or serum-like, or it may be heavier, something like granulations. The tissues are weak they exude something in their distress, in their attempt to correct this condition when they have been inflamed. "The pupil of your eye is the aperture, the stop of the lens. That is the hole through which the light passes. Around it lie the tissues of the iris.
A suppurative arthritis, like that caused by ordinary pus microbes, may be the result of gonococcal infection alone or of a mixed infection. Usually only one joint is affected, but the condition may be multiple. The articular cartilages are destroyed, the ends of the bones are covered with granulations, extra-articular abscesses form, and complete osseous ankylosis results.
They should be cut oval or spindle-shaped, to facilitate the approximation of the edges of the resulting wound. The graft should be cut to the exact size of the surface it is to cover; Gillies believes that tension of the graft favours its taking. These grafts may be placed either on a fresh raw surface or on healthy granulations.
Skin grafting of granulating surfaces is chiefly employed to promote healing in the large defects of skin caused by severe burns; the grafting is carried out when the surface is covered by a uniform layer of healthy granulations and before the inevitable contraction of scar tissue makes itself manifest.
The dead portion is then cast off, the irritation resulting from the contact of the dead with the still living tissue inducing the formation of granulations on the proximal side of the junction, and these by slowly eating into the dead portion produce a furrow the line of demarcation which gradually deepens until complete separation is effected.
#The Skin.# The skin was the first tissue to be used for grafting purposes, and it is still employed with greater frequency than any other, as lesions causing defects of skin are extremely common and without the aid of grafts are tedious in healing. Skin grafts may be applied to a raw surface or to one that is covered with granulations.
In moderately acute cases the tendon and its sheath become covered with granulations, which subsequently lead to the formation of adhesions; while in more acute cases the tendon sloughs. The pus may burst into the cellular tissue outside the sheath, and the suppuration is liable to spread to neighbouring sheaths or to adjacent bones or joints for example, those of the wrist.
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