File:The breast- its anomalies, its diseases, and their treatment (1917) (14734064546).jpg

Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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uts the pectoral muscleon the stretch. The muscles are then shaved from their points of attachment to the chest wall. That position of the arm on the operated side should be chosen which gives the patientthe greatest degree of comfort. Owing to the padding in the axilla it is necessary tokeep the arm in a somewhat abducted position, however, and this is best accomplishedby supporting the member on pillows while the patient is put in a semi-sitting position;mechanical devices to maintain the arm in a fixed position are unnecessary and may beharmful. The after-care of patients on whom skin grafting has been done is described elsewhere. CARCINOMA 597 Post-operative Complications.—Among the 50 consecutive cases mentioned above,there were 12 more or less serious complications, including the only instance of death fromsepsis complication of a breast operation that has occurred in our experience—one ofthe few cases in which we have been obliged to resort to intravenous saline transfusion
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Fig. 216.—The breast and pectoral muscles are in the grasp of the left hand and are being dissectedfrom the chest wall. It will be observed that the upper portion of the rectus abdominis sheath has beenremoved. The long thoracic nerve remains intact. to combat serious post- operative shock—and the only case in which it has been necessaryto make a second incision in the axilla to recover a drainage tube that had slipped intothe axillary space. The series is fairly representative of the complications that mayarise after the radical removal of the breast, which are as follows: 598 THE BREAST Case I.—Upper end of the wound broken down. Case 2.—Arm became very swollen and the wound opened; no infection. Arm was elevated and hotbichloride dressings applied; uneventful recovery. Case 3.—Lower part of the wound opened; infected.

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