Preparatory and after treatment in operative cases . Fig. 57.—Silk onSpools. (Bryant.) 100 SUTURE AND LIGATURE MATERIAL Silk, on general principle, should not be used for ligatures orburied sutures. It is being less and less used as the art of pre-paring absorbable suture material becomes perfected. It has a distinct field of usefulness in intestinal surgery. Forthis purpose, a very fine grade of silk is used,and should be dyed black so as to permit ofcloser scrutiny when being placed in situ. Theoperative field is apt to be bloody, and whitesilk soon takes on the color of the medium inwhich i
Preparatory and after treatment in operative cases . Fig. 57.—Silk onSpools. (Bryant.) 100 SUTURE AND LIGATURE MATERIAL Silk, on general principle, should not be used for ligatures orburied sutures. It is being less and less used as the art of pre-paring absorbable suture material becomes perfected. It has a distinct field of usefulness in intestinal surgery. Forthis purpose, a very fine grade of silk is used,and should be dyed black so as to permit ofcloser scrutiny when being placed in situ. Theoperative field is apt to be bloody, and whitesilk soon takes on the color of the medium inwhich it is being used. If a reliable absorbablesuture material of sufficient tensile strength andas great pliability as silk were devised, an ideal^ N,,,,JJIliNll intestinal suture would be Silk is being; used for deligating large pedicles and the broad ligament in salpingec-tomy. It should never be used for the latterpurpose, and but rarely for the former. Silksutures or ligatures, while they, more especiallyin regard to the latter, give the surgeon a feel-ing of security as to the permanency of the knot,give rise to adhesions, because of the prolongedirritation common to all foreign bodies in thetissues, and not infrequently they are the causa-tive factor in intestinal obstruction followingceliotomy. In intestinal suturing the area ofexposed suture is so small as to be perhaps aminor factor in this connection, yet non-absorbable suture ma-terial in closed cavities is never as desirable an agent for repairas the kind which is taken up by the circulating fluid. For operations in private practice silk may be preserved inglass tubes. The braided (Fig. 59) and the twisted (Fig. 60) areboth put up in this way. Fig. 58. -Wide-mouthed Bottlefor Ligatures.(Bryant.) PAGENSTECHER
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishernewyo, bookyear1910
