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section of hand through web of finger; interossei. is there a generic nexium web. Treated in time, nothing serious will generic brand for nexium happen ; but delay is dangerous, for this little abscess in the web can, in a few days, when will nexium become generic extend directly into the palm, and while recovery is to be expected, the hand will never be as good what is the generic name for nexium as it formerly was, once it has sulTered from a deep palmar abscess. At the beginning, metastatic abscess in the web is not very painful. There is plenty of room for the exudate ; therefore the pressure is not great at first. At the same time, the pain at the original site of infection is great and distracts the patient's attention. If the diagnosis of metastatic abscess is not made before the patient directs attention to it, it is too late to prevent him from having a deep pal- mar abscess. How then shall we make the diag- nosis? First, by being aware of the fact that here is the first site for the development of a metastatic abscess, and that metastatic abscesses may develop here in any kind of finger infection, but most often in those of nexium 40 mg generic the skin and subcutaneous tissues ; and secondly, what is the generic for nexium by looking for the abscess generic version of nexium in the web. Pain on pressure over the web is a sign that infec- tion is present. One may elicit tenderness deep in the web within a few hours after the infection begins there, nexium dosage 80 mg and when first the diagnosis is made is the time to treat the condition. Never wait for that sign which even fools may read — fluctuation. Re- member that to delay, means to provoke a palmar abscess. Fig. 4 illustrates the proper way to open a web. Cut straight through it for at least half an inch from its free edge, and if pus -is not found, open bluntly through the fat in the middle of the incision still further toward the palm. If one cuts back farther than the point where the pus is, he will carry the infection into the palm. Insert a thin bit of rubber to keep the wound edges from agglutinating and dress the fingers wide apart. Immobilize the whole hand and forearm and immerse all in 80 mg nexium a hot bath as before. Do not practise changing the drains daily and never pack a wound in which there is virulent or viscid pus. The web abscess in any of the three inner spaces is there a generic for nexium spreads by direct continuity into the fat of the palmar pad and thus an infection of any one web may lead to infection of all the others. I have often seen this happen. Now how does the web abscess become a palmar abscess ? The kunbrical muscles are found deep in the palm. Springing from the tendons of the deep finger flexors, they run downward and pass to the radial side of the base of the corresponding finger ; going through the base of the web, they insert into the tendon found lying on the back of the first phalanx — the common extensor of the fingers. The tendons of the interossei do almost the same. Thus the fat of the web comes into actual contact with these tendons. Each tendon is surrounded with loose areolar tissue — a lymph space — and so it is easy for pus, having once come into direct contact with a tendon to dissect its way along it. Infection (metastatic) of the web of the first space is in a class by itself, inasmuch as it is nearly generic for nexium 40 mg always intermuscular from the beginning. It fol- lows infection of either thumb or index finger and can occur by direct extension of pus along peri- fascial lymph spaces, or buy generic nexium by the ordinary lymphatic route to the base of thumb or index, and then along muscle tendons into the intermuscular space between when does nexium go generic the first dorsal interosseus muscle and the adductors of the thumb. generic name for nexium As before, tenderness on deep pres- sure is the sign to watch for, and the space should be opened as soon as that sign appears. Fig. 4 shows the incision directly across the web. It continues through the superficial and deep fasciae until the edges of the muscles are seen. The lines of their fibres cross each other x wise. The space between the two is found and opened by blunt dissection. The pus is there. A drain is inserted to the bottom of the abscess cavity and fastened there. generic equivalent of nexium The whole hand and forearm are immobilized with thumb and index slightly separated. An order nexium samples abscess in this web can readily become a palmar abscess by does nexium have a generic dissecting its way around the edge of the adductors of the thumb, or along the palmar arch, or it can spread easily to the wrist along the synovial sheath of the flexor longus pol- licis. In dealing with abscess in this web, generic form of nexium no muscle of what is generic for nexium palm is cut. Through and through drainage is never used. We shall briefly consider abscess in the palm.

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