Treatise on gynæcology : medical and surgical . t the deeper surface of the abdominal wall; it is fixed there,close to the peritoneal incision, by passing through it on each sidea carbolized silk suture which traverses its superficial layers and TREATMENT OF FIBROUS TUMORS OF ABDOMINAL EVOLUTION. 297 then the abdominal walls. The ends of the silk are looped over smallrolls of iodoform gauze and tied so that the surface of the stump isheld between the lips of the peritoneal wound. The edges of theparietal peritoneum are not sutured together at this point, but arecarefully stitched around the to
Treatise on gynæcology : medical and surgical . t the deeper surface of the abdominal wall; it is fixed there,close to the peritoneal incision, by passing through it on each sidea carbolized silk suture which traverses its superficial layers and TREATMENT OF FIBROUS TUMORS OF ABDOMINAL EVOLUTION. 297 then the abdominal walls. The ends of the silk are looped over smallrolls of iodoform gauze and tied so that the surface of the stump isheld between the lips of the peritoneal wound. The edges of theparietal peritoneum are not sutured together at this point, but arecarefully stitched around the top of the pedicle so that it, as regardsthe abdominal cavity, is extra-peritoneal, and yet juxta-parietal. Theabdominal walls are then sutured, leaving only room for a band ofiodoform gauze and the drain which is passed down to the pedicle(Figs. 159,160). The first two cases of Wolfler and Hacker recovered with butlittle suppuration or sloughing; both would probably have died ofseptic peritonitis if the pedicle had been abandoned within the ab-. Fig. 160.—Woelfler-Hackers Mixed Treatment of the Pedicle, c, Skin; m, muscles; pp. parietalperitoneum; pv, visceral peritoneum; ut, pedicle; a, cutaneous suture; 6, muscular suture; c, peritonealsuture with catgut; e, pedicle supports on rolls of iodoform gauze. Transverse section; diagrammatic. dominal cavity; then followed a number of cures by first adopted the method, and obtained nineteen successive suc-cesses, while Olshausens and Schroders method had given twelvedeaths in thirty-nine cases. Although I have not adopted it ex-clusively, it is certain that the method is a very useful one, for itis applicable both to large and to short pedicles, which could notbe drawn out of the abdominal wound without too much effortand where the abundance of the vessels and the number of theligatures would render abandonment in the abdomen dangerous, be-cause of the probability of secondary hemorrhage, mortification, andseptica
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