. An American text-book of obstetrics. For practitioners and students. passing the end through the cervix into the vagina, toprovide free drainage and to guard against intra-uterine hemorrhage by stimu-lating contraction. This practice is unnecessary in most cases unless the uterinemuscle is flabby and weak and does not contract well. Tlie Uterine Suture.—Silver wire, silk, and catgut sutures are employed,but, on the whole, silk or well-prepared catgut seems to be preferable. Mostoperators use two sets of interrupted sutures—a deep layer to approximate thedivided muscular coats, and a superfic
. An American text-book of obstetrics. For practitioners and students. passing the end through the cervix into the vagina, toprovide free drainage and to guard against intra-uterine hemorrhage by stimu-lating contraction. This practice is unnecessary in most cases unless the uterinemuscle is flabby and weak and does not contract well. Tlie Uterine Suture.—Silver wire, silk, and catgut sutures are employed,but, on the whole, silk or well-prepared catgut seems to be preferable. Mostoperators use two sets of interrupted sutures—a deep layer to approximate thedivided muscular coats, and a superficial layer to close the peritoneum. Thedeep sutures of Xo. 2 silk pass from 3 to 6 millimeters (\ to \ inch) from theborder of the incision diagonally down through the muscular tissue to, but do 922 AMERICAN TEXT-BOOK OF OBSTETRICS. not include, the decidual lining (Figs. 509, 510). They are about J inch apart,and are eight to twelve in number, according to the length of the wound. Assoon as they are all introduced the uterine cavity is irrigated with a hot sub-. Fig. 509.—The deep suture placed as a runningstitch ; it includes peritoneal and muscular coats,hut not decidual lining (modified from Grandin). Fig. 510.—The running stitches of the deep su-ture cut to form interrupted sutures (modifiedfrom Grandin). limate solution, the sutures are tied securely, and the ends are cut short. Thesuperficial sutures of catgut or of No. 4 silk are then put in to bring the peri-toneal borders into close apposition (Figs. 511, 512). The Lembert suture isgenerally employed for this purpose, though it is claimed that equally goodresults may be obtained by simply approximating the cut edges. One super-ficial suture is introduced over each deep one, and another midway between, PeritonealSuture
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
