HEMATOMA.
11,ematoma of the Auricle usually resolves more or less completely if left to itself, but since the effused blood is bound firmly down by the unyielding perichondrium, deformity through shrinkage of the cartilage. is liable to ensue. If the extravasation is small and seen early the appli cation of an ice-bag may meet all requirements. In more extensive hxmorrhages puncture is seldom justifiable, since the blood has usually coagulated already. The best procedure is to make under aseptic pre cautions a free incision through which the clot is to he turned out and the cavity carefully packed by antiseptic gauze so inserted as not to interfere with the configuration of the auricle, a firm padding of cotton wool being placed behind the ear. A woven bandage should be applied with sufficient firmness to secure a moderate degree of pressure.
Ihumatoma of the Labium should be treated when seen early by the application of the ice-bag to check further extrayasation, and if let alone small tumours will usually resolve spontaneously, but a large hiematoma in this region is liable to suppurate, and should be freely incised, the clot turned out, the cavity swabbed with Perchloride of Mercury solution, and any bleeding vessels tied, after which measures the cavity should be firmly packed with Iodoform or Cyanide gauze.
In neglected cases, where suppuration has already set in, the pus should be evacuated by a free incision and the cavity thoroughly flushed out by a warm antiseptic solution and thorough drainage provided.
In eases of long standing the walls become thickened by organised layers of clot, as when the luematoma supervenes upon a varicocele of the labium, in which case the entire mass will require excision.
Ikematoma of the Scalp.--When the extravasation occurs into the space beneath the aponcurosis, the diffusion of the tumour may be prevented by the application of an ice-bag and gentle uniform elastic pressure. Its resolution at a later stage may be expedited by careful massage.
The Cephallumatomata observed in newly born children usually result from extravasated blood between the bone and the pericranium, and generally yield to the application of evaporating lotions, the ice-bag, and at a later stage, should these not prove effectual, to the mild elastic pressure exercised by a woven bandage over a Spirit lotion applied under oiled silk. Poulticing, aspiration, leeching or puncturing should never he resorted to. Should suppuration occur, a free incision should be made into the centre of the buggy swelling, the pus evacuated and the cavity washed out by a warm antiseptic solution, after which it may he loosely packed with gauze or drained.
Haematoma of the Scrotum must be differentiated from it always yields to rest in bed, with the testicles supported on a suitable splint or shelf and the application of cold lotions, followed at a later stage by the use of Spirit lotion under oiled silk and a suspensory bandage. For Pelvic liamatoina, see p. 358.