Over the wound is then placed a protective layer of gauze, impregnated either with boric acid, with a mercuric salt, or with iodoform.
Finally, numerous small and lightly-rolled balls of dry carbolized tow are packed regularly over the whole of the operation wound, and the foot bandaged.
Practical points to be remembered in this after-dressing are: (1) The balls[A] of tow should be numerous enough to exercise pressure upon the sutured flap when the foot is finally bandaged. (2) The bandage should be run on from the coronet downwards, in order to insure pressure being exerted in the exact position over the sutured flap. (3) Bandages should be used in abundance, commencing always from the coronet, and carefully applied so as to exert an even and uniform pressure. (4) The bandages should be of clean, unused linen.
[Footnote A: Bayer recommends that the tow be rolled into cylindrical tampons, each long enough to cross the wound. These are placed on the wound in alternate horizontal and vertical layers, so that when rolled round by a bandage they are pressed into an even and compact pad.]
Once the bandages are adjusted, the hobbles may be removed, and the tourniquet loosened. Directly the tourniquet is removed there is a steady oozing of blood through the bandages, no matter how many we have put on. This should occasion no alarm, as experience has taught that the careful attention to antiseptic measures observed throughout the operation has the effect of maintaining the lowermost dressings, those next to the wound, in a state of asepsis. The bandaged foot should now be wrapped in a piece of thick clean cloth or placed in a boot.
If our antiseptic precautions have been thorough, the dressings and bandages so adjusted may be allowed to remain without disturbance for from eight to fourteen days. In this, however, the veterinary surgeon must be largely guided by the symptoms of his patient. If, at the end of the first three or four days, the animal maintains a vigorous appetite, if he commences to place a little weight on the foot, and if the thermometer gives no indication of a rise beyond the one or two degrees of ordinary surgical fever, then the surgeon may know that things are proceeding satisfactorily. Pawing movements with the foot, inability to place weight upon it, loss of appetite, an increase in the number of respirations, and a serious rise of temperature, denote the opposite state of affairs. The wound is in all probability suppurating. The bandages and dressings should therefore be removed, and the wound either redressed and bandaged, or treated as an ordinary open wound.
Ordinarily, however, if the operation has been properly performed, healing takes place by first intention, and the wound when the bandages are removed at the end of the first or second week appears clean and dry.
Having assured ourselves that such is the case, we dress the foot in exactly the same manner as before, save that so many bandages are not put on. A similar dressing is repeated weekly until such time as the wound shows sufficient growth of horn—quite a thin pellicle—to act as a protective. It may then be left undressed, except for some simple hoof dressing and a bandage.
Complete healing of the wound takes from about four to eight weeks, at the end of which time the animal can be again gradually put into work. The labour, however, should be light, and quite three or four months should be allowed to elapse before any attempt is made to put him to heavy work.
Should the second method of operating have been the one adopted, then there is one slight difference in the after-dressing that needs attention calling to it. In this case we have more or less of a hidden cavity left to deal with rather than the broad and open wound left in either of the other methods. This cavity, left by the extirpation of the cartilage, must be thoroughly dressed with iodoform or chinosol, or with Bayer's iodoform in ether. The packing with carbolized tow and the bandaging may then be proceeded with as before.