Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . woundsis the same as that of rupture of the intestine. Penetrating wounds of theabdomen have been described (page 535). Perforating bullet wounds shouldbe exposed if the surgeon can control the asepticity of the operation. Withthe modern small-caliber bullet these wounds are by no means always fatal,and if aseptic and skillful surgery is not available the patient has a betterchance for his life by the application of an occlusive dressing, and the treat-ment for pe
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . woundsis the same as that of rupture of the intestine. Penetrating wounds of theabdomen have been described (page 535). Perforating bullet wounds shouldbe exposed if the surgeon can control the asepticity of the operation. Withthe modern small-caliber bullet these wounds are by no means always fatal,and if aseptic and skillful surgery is not available the patient has a betterchance for his life by the application of an occlusive dressing, and the treat-ment for peritonitis (see Peritonitis, page 546). This treatment should beapplied from the first, and peritonitis not awaited. The essentials are restand the inhibition of peristalsis. Ordinarily the treatment of these wounds, as for incised, punctured, andlacerated wounds of the intestine, is immediate exposure and a median abdominal incision is best. Bullet wounds should beclosed by a single very fine purse-string suture. Small incised wounds requirea single suture. Larger wounds, involving a distance equal to more than. Fig. 1221.—Suturing Wound of Intestine gives the least narrowing of the lumen. one-third of the circumference of the bowel, may be closed by two layers ofsuture. If the suturing of a wound reduces the caliber of the bowel morethan one-half, resection is to be preferred. Transverse wounds threatenthe vitality of the bowel less than longitudinal wounds. Wounds should besutured in such a manner that the caliber of the bowel is not reduced ( and 1222). This is best accomplished by sewing wounds transverselyto the long axis of the bowel whenever possible. If the wound is not found at once, the direction from which fluid or bloodcomes is the guide. If it is still not iound, or after a single wound has beenfound and the injury was inflicted in such a way as to warrant the suspicionthat other coils were wounded, a systematic examinati
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
