. Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases as practised by prominent American and European surgeons. be into the end of therubber tube, so that its weight will keep it from becoming dislodgedfrom the bottle. If the presence of the rubber tubes gives rise to pain,their position should be changed occasionally. (See Fig. 80.) If the operation is performed for the removal of a stone from a healthybladder containing nearly normal acid urine, the wound in the bladdermay be closed by a double row of catgut sutures, which are n
. Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases as practised by prominent American and European surgeons. be into the end of therubber tube, so that its weight will keep it from becoming dislodgedfrom the bottle. If the presence of the rubber tubes gives rise to pain,their position should be changed occasionally. (See Fig. 80.) If the operation is performed for the removal of a stone from a healthybladder containing nearly normal acid urine, the wound in the bladdermay be closed by a double row of catgut sutures, which are not per-mitted to penetrate the mucous membrane, however. The spacebetween the bladder and the abdominal wall should always be drainedthoroughly in these cases for fear of extravasation of urine. A soft-rubber retention catheter is placed into the bladder through the urethrain such instances and carefully fastened in place, so as to keep the 278 POSTOPERATIVE TREATMENT. bladder thoroughly drained. If there is any doubt about the asep-tic condition of the bladder, it does not seem wise to close the bladderwall completely, in which case the wound is treated after the open. Fig. 80.—Showing Y Tube Used for Drainage and Irrigation after Supra-pubic Cystotomy. method, with fresh gauze packing daily, and healed from the bottomby granulation. Senn advises two stages in the operation in cases of septic cystitis: OPERATIONS UPON UTERUS, BLADDER, KIDNEYS, ETC. 279 After the anterior wall of the bladder has been exposed and all hemor-rhage arrested, the wound is packed with iodoform gauze and the dress-ing held in place by strips of adhesive plaster; this dressing is allowedto remain for five days; at the end of this time the wound, if it has re-mained aseptic, is covered with a layer of healthy granulations, which haveclosed the connective tissue channels and have shut out from the woundthe remainder of the prevesical space. As a second stage, with thedanger of infiltration lessened by
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