Читать книгу Special Report on Diseases of the Horse - Charles B. Michener - Страница 105

A wound penetrating the wall of the chest admits air into the thoracic cavity outside the lung. This condition is known as pneumothorax and may result in collapse of the lung. The wound may be so made that when the walls of the chest are dilating a little air is sucked in, but during the contraction of the wall the contained air presses against the torn part in such manner as entirely to close the wound; thus a small quantity of air gains access with each inspiration, while none is allowed to escape until the lung is pressed into a very small compass and forced into the anterior part of the chest. The same thing may occur from a broken rib inflicting a wound in the lung. In this form the air gains access from the lung, and there may not be even an opening in the walls of the chest. In such cases the air may be absorbed, when a spontaneous cure is the result, but when the symptoms are urgent it is recommended that the air be removed by a trocar and cannula or by an aspirator.

It is evident that the treatment of wounds that penetrate the thoracic cavity should be prompt. It should be quickly ascertained whether or not a foreign body remains in the wound; then it should be thoroughly cleaned with a solution of carbolic acid, 1 part in 40 parts of water. The wound should then be closed immediately. If it is an incised wound, it should be closed with sutures or with adhesive plasters; if torn or lacerated, adhesive plaster may be used or a bandage around the chest over the dressing. At all events, air must be prevented from getting into the chest as soon and as effectually as possible. The after treatment of the wound should consist principally in keeping the parts clean with a solution of carbolic acid, and applying fresh dressing as often as required to keep the wound in a healthy condition. Care should be taken that the discharges from the wound have an outlet in the most dependent part. (See Wounds and their treatment, p. 484.) If pleurisy supervenes, it should be treated as advised under that head.