Needless to say, absolute sterility of the field of operation and of all media is essential. In the event of failure in cleanliness, however slight, it will become necessary to reopen the wound and remove the plate. In such cases a second attempt may be made at a later date.
Results.
The results attained by operative treatment must always be considered under two headings: the immediate and the more remote.
The immediate results are almost always of a satisfactory nature, the fits being more or less completely controlled, or so diminished in quantity and quality as to satisfy both surgeon and patient. Such early results may be regarded as the general rule, and some enthusiasts believe that the ultimate results are equally satisfactory. However, in following up these cases, it will be found that, in a considerable proportion of cases, the more remote results are by no means so satisfactory. A complete and permanent cure is seldom obtained, though the great majority of cases evidence considerable improvement, the fits recurring, though less frequent and less intense than previous to the operation.
The results which may be obtained should therefore be considered as follows:—
Cases of complete and permanent cure.
Cases of definite amelioration.
Cases in which no benefit is derived.
In 20 cases that have come under my own care, the following results were obtained:—
Complete cure in 2.