Fig. 131
Neglected suppurating thecitis resulting in palmar abscess. (Burrell.)
Fig. 132
Same, dorsal aspect. (Burrell.)
A more striking example of similar trouble is that which gives rise to palmar abscess, the suppurative process extending up the wrist beneath the annular ligament, and down into the little finger and thumb. This is not infrequently the result of infection of callosities in the palm of the hand. Infection may travel rapidly, and when confined beneath resisting structures will prove exceedingly destructive; the muscles of the forearm may melt down and great permanent damage be done.
Here, as when the finger alone is involved, early, free, and deep incision will prove the salvation of the part. These incisions should be made as indicated in [Figs. 133] and [134], i. e., parallel with the nerves, tendons, and vessels, all of which should be spared, as well as the palmar arch. Should the latter be divided, the vessel ends may be ligated or the wound packed. If cavities be left by the destructive process they should be opened and the part treated by continuous immersion in warm water, or the openings may be packed with gauze saturated in brewers’ yeast. A few days of this treatment will clean up all sloughs.
Fig. 133
