A system of surgery . coats quickly snap across and roilup inside, whilst its tough and elastic outer coat curls up intoa knob at its extremity (Fig. 145). An internal coagulumforms, and is protected against expulsion by the knob of outer the artery be insufficiently twisted, the outer coat untwists,and the vessel opens out again. If the vessel be overtwisted, thecoiled-up outer coat is separated, and the clot loses its protection,and is apt to be displaced. The forceps should have broad endsand be bluntly serrated, so as to seize the whole artery and nottear it. Care should be taken t
A system of surgery . coats quickly snap across and roilup inside, whilst its tough and elastic outer coat curls up intoa knob at its extremity (Fig. 145). An internal coagulumforms, and is protected against expulsion by the knob of outer the artery be insufficiently twisted, the outer coat untwists,and the vessel opens out again. If the vessel be overtwisted, thecoiled-up outer coat is separated, and the clot loses its protection,and is apt to be displaced. The forceps should have broad endsand be bluntly serrated, so as to seize the whole artery and nottear it. Care should be taken to seize the artery cleanly, andin the case of a large vessel «iot to introduce one blade into itslumen. Torsion may be trusted to close even the largestarteries, and it has the advantages over ligature that the operatorrequires no assistance, that it is done very rapidly, and thatit does not introduce any foreign material into the of the inner and middle coat of an a^ery is not a bar to HEMORRHAGE. 519. Fig. 145.—Arteryclosed by Tor-sion, showingthe curled-upouter Coat ofthe Artery forming atwisted Knotover the endof the Artery. successful torsion, but extreme fragility and loss of elasticity of theouter coat is a bar, and so also is adhesion of an artery to its sheath,for it prevents the vessel from twisting freely. Yeinscan be closed by careful torsion as well as arteries. Ithas been suggested that torsion should be used for smallarteries and the ligature for large vessels, and thatthe torsion forceps should be twisted off. Both sug-gestions are bad. Torsion is perhaps better adaptedfor large than for small arteries, because they canbe seized more cleanly. Most certainly the forcepsshould not be twisted off, for the cuvled-up knob ofthe vessel wall is a great security, resembling in itsusefulness a firmly adherent external clot. The late changes occurring in a twisted artery areclosely like those met with in an aseptic vessel. Thethrombus is organised in the
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Keywords: ., bookcentury1800, booksub, booksubjectsurgicalproceduresoperative
