Operative surgery . afford asuitable field of effort in thisregard. The Operation {Fusi-form Aneurism).—Elevatethe limb and apply Es-marchs bandage or othersuitable agent so as to arrestthe circulation in the tumor;expose and open from endto end through a free inci-sion in its long axis theaneurismal sac; retract fullythe divided borders of thesac; evacuate the contents,exposing the interior toview; examine carefully theinterior for collateral open-ings, closing those that bleedby pressure until all aresecurely shut by sewing;scrub gently and thoroughly with oauze wet with saline ^^^ ^^^—^^^ i
Operative surgery . afford asuitable field of effort in thisregard. The Operation {Fusi-form Aneurism).—Elevatethe limb and apply Es-marchs bandage or othersuitable agent so as to arrestthe circulation in the tumor;expose and open from endto end through a free inci-sion in its long axis theaneurismal sac; retract fullythe divided borders of thesac; evacuate the contents,exposing the interior toview; examine carefully theinterior for collateral open-ings, closing those that bleedby pressure until all aresecurely shut by sewing;scrub gently and thoroughly with oauze wet with saline ^^^ ^^^—^^^ interior of a fusiform aneurismal sac,, , .* ,, • , • n showing openings and groove of main vessel and solution the interior ot opening of collateral branch,the sac, removing laminated blood and stimulating the surface to quicker plastic action (Fig. 235), closewith a suitable curved needle armed with chromicized catgut by continuousor interrupted sutures carried, as indicated (Fig. 236), through the borders. * Transactions of American Surgical Association, 1902. 208 OPERATIVE SURGERY. of the two main openings and those of the corresponding intervening wall ofthe sac; remove all agents of constriction and permit restored circulation to test the security of thesewing; close bleedingpoints by additional su-tures if needed, and in-troduce if practicable asecond row of sutures(Fig. 237), thus lesseningthe size of the cavity andburying the first row; in-sert two or more chromi-cized catgut sutures intoeach side of the floor ofthe sac, then pass theirfree ends through the in-folds of the sac (), thence through theskin to the external sur-face (Fig. 239) ; unitethe free borders of the
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
