Descent of Testis in Relation to Temperature

TABLE III.-Antalysis of Series C (Infected, Non-penicillin) Average Time Average Time Type of Case No. of Cases Wounding to Operation to Limb-fitting Limb-fitting Open wounds Healed 5 41 weeks 201 weeks still present Unhealed 2 at operationJ Infected cases Healed 6 5 32 ,, 21 Unhealed .. 6 Penicillin Series Control Series All Cases Combined Site of Amputation or No. Average Time No. Average Time No. Average Time Re-amputation of Operation to of Operation to of Operation to Cases Limb-fitting Cases Limb-fitting Cases Limb-fitting Above elbow 2 101 wecks 6 9 weeks 8 91 weeks Belowelbow.. 2 11 ,, 10 51 ,, 12 6, Above knee .. 19 9 ,, 11 71 ,, 30 8 , Below knee .. 11 12 ,, 29 12 ,, 40 12 and those not receiving post-operative penicillin.The results are given for the various amputation sites.It should be noted that the most difficult site to obtain a good result is below the knee, all but 2 of the 12 cases of delayed healing being below- knee amputations.Conclusions The best indications of the success of an amputation or re- amputation are: first, the shortness of time between operation and readiness of the stump for limb-fitting; secondly, the sub- sequent behaviour of the stump under the strain of wearing an artificial limb.Time alone can show the latter, but the former can be worked out quite easily and gives a reasonable index of the degree of success.It may be added that a rapidly healing stump is usually sounder than a slowly healing one.Broadly speaking, these series give us the results in 3 types of case.First, potentially or actually infected cases receiving post-operative penicillin ; secondly, uninfected cases not receiving penicillin ; and, thirdly, potentially or actually infected cases not receiving post-operative penicillin.It is evident that in the uninfected cases the results were best, but they were only slightly better than in the infected cases receiving post-operative penicillin ; the relevant average times of healing were 7 and 10 weeks respectively.It should be remembered that many of these infected cases had been grossly infected, and could not have undergone re-amputation for weeks or months later had it not been possible to administer post-operative penicillin ; yet there were no failures in this series and only 3 cases of delayed healing.In the third series, even with 8 failures not included, it is found that the average healing-time was 21 weeks-more than twice the period in similar cases which had received penicillin after operation.From these results it can be claimed that the use of penicillin not only shortens the time between operation and limb-fitting.but makes it poss.bleto operate on doubtful cases considerably earlier than would otherwise be feasible.Convalescence is shortened and a far better prospect of success is assured.Summary A report is given of 102 amputations and re-amputations.Of these 55 were infected or potentially so at the time of operation; 34 of them received post-operative penicillin and 21 did not.The results show that, in selected cases; it is possible to operate on infected cases much earlier with than without penicillin, and with