A  narrow  strip  of  cleansed  gutta-percha  or  protective
is  laid  along  the  cut,  and  small  compresses  of  damp  gauze
laid  an  inch  deep  over  this.  Over  all  a  square  of  thin
gutta-percha  tissue  will  keep  the  dressing  damp  and  favor
the  drainage  of  the  capillary  oozing  from  the  cut.  A  firm
bandage  should  be  applied  before  the  Esmarch  bandage
is  taken  off.
The  completed  operation  and  dressing  is  done  within
twenty  minutes,  which  I  have  found  to  be  about  the  limit
of  time  that  most  patients  can  comfortably  bear  a  snug
Esmarch  bandage.
The  first  dressing  should  be  changed  in  twenty-four
hours  ;  the  second  on  the  fourth  day,  when  stitches  may
be  removed.
Contrary  to  the  custom  of  Mr.  Adams,  who  puts  on  a
straight  splint  at  once,  I  have  found  it  better  to  let  the
fingers  assume  a  comfortably  correct  position,  under  a
dressing  without  splint  (which  will  often  induce  pain  by
overstretching),  and  I  put  on  no  splint  until  a  week  has
gone  by  and  the  parts  are  healed.
Although  I  have  records  in  my  private  notebook  of
fifty  cases  of  Dupuytren's  contraction,  representing  about
that  number  of  operations,  I  have  never  seen  a  case  of
suppuration  after  operation,  although  most  of  those  of
the  last  four  years  have  been  excised.
The  paralytic  and  inflammatory  deformities  of  the  hand
—so-called  "  main-en-griffe"—are  to  be  carefully  distin-
guished from  Dupuytren's  contraction  before   operation,


gro  ABBE  :    Wesley  M.  Carpenter  Lecture  :

the  tendons  in  such  cases  being  contracted,  but  buried  in
the  flat  palm  and  not  raised  like  the  bands  of  the  latter.
