The exposed soft tissues are then dressed with pledgets of tow[A] soaked in alcohol and carbolic acid.  This dressing must be allowed to remain in position, and is kept there by means of a bandage, or the shoe with plates (Fig. 55) and a bandage over it.  No pressure is needed; consequently, the pledgets of tow must not be too thick.

[Footnote A:  When using tow in the form of a pad, it is well to remember that many small balls of the material rolled lightly in the palm of the hand and afterwards massed together are far better than one large pad of the tow taken without this preparation.  The irregularities of the wound are better fitted, and the whole dressing easier remains in situ (H.C.R.).]

In the after-dressing of the wound careful attention must be paid to the granulating surface.  Where tending to become too vigorous in growth it should be held in check by suitable caustic dressings.  At the same time it must be remembered that the granulating process of repair is always more rapid upon the plantar cushion and fleshy sole than upon the bone, or upon tendinous or cartilaginous structures.  As a result of this we have a wound showing various aspects of cicatrization.  Healthy granulation may be profuse in one spot, while in another it may be checked either by a flow of synovia from the still open bursa, or by fragments of bone or of tendon still acting as foreign bodies in the wound.  These latter may be readily detected by their standing out as dark and uncovered spots in the healthy granulation around, and should be at once removed.

The time that an operation wound of this description takes to heal—­and that without complication—­is from one to two or three months.  Continuation of pain and intensity of lameness are not to be taken as indications of failure.  The reparative inflammation in the synovial membrane is quite sufficient to induce pain severe enough to prevent the animal from placing his foot to the ground for some weeks, even though the progress of the case, all unknown, may be all that is desired.  So long as a great amount of pain is absent, and so long as appetite remains and swellings in the hollow of the heel fail to make their appearance, so long may the progress of the case be deemed satisfactory.

Recorded Case of the Treatment.—­A cart-horse, aged six years, was sent to the Alfort School by a veterinary surgeon for having picked up a nail in the hind-foot.  Professor Cadiot, judging the necessity for the complete operation, performed it on January 14, and spared the plantar cushion as much as possible.  In consequence of the plantar aponeurosis being extensively necrosed, it was advisable to scrape the navicular bone and a part of the semilunar crest.  The wound having been washed with a 1 per cent. solution of perchloride of mercury, it was dusted with iodoform and packed with gauze, and covered with a cotton-wool dressing, kept in position by means of a suitable shoe.