Abdominal surgery . be done bycatching the edges of the laceration in forceps, pulling it intothe wound, and surrounding it with a ligature. This producesperfect closure, with apposition of serous surfaces. I have, onone occasion, seen this done, and no harm result. If the bowel is distended with faeces, the ends and deep partsof the parietal wound should be closed before opening it. There is always some risk of burrowing suppuration ; andaccurate apposition of deep as well as superficial parts ought tobe secured. The best way to do this is by continuous buriedsutures of catgut carried from th
Abdominal surgery . be done bycatching the edges of the laceration in forceps, pulling it intothe wound, and surrounding it with a ligature. This producesperfect closure, with apposition of serous surfaces. I have, onone occasion, seen this done, and no harm result. If the bowel is distended with faeces, the ends and deep partsof the parietal wound should be closed before opening it. There is always some risk of burrowing suppuration ; andaccurate apposition of deep as well as superficial parts ought tobe secured. The best way to do this is by continuous buriedsutures of catgut carried from the deep parts of the wound to its surface; but deep silver-button sutures answerfairly well. A drainagetube is placed deeply atthe end of each half ofthe wound. To provideagainst the contact offaeces, the wound mustbe protected by lintsoaked in some anti-septic material, of whichthere is nothing betterthan boro - glyceride. If there is much diffi-culty in seizing an un-dilated colon, a Lundsinsufflator (Fig. 31) may. Fig. 31. Lunds Insufflator. _ A, hollow rubber ring which is pressed against thetissues around the anus; a, rectum tube ; C, longerrectum tube ; B, ball-syringe attached to instrument. See Lockwood, St. Hosp, Rep., vol. xix. THE OPERATION. 399 be used, to cause its distension by air or fluid. Some surgeonsrecommend that the operation be begun by artificially dis-tending the colon. If there is complete obstruction in therectum, this is, of course, impossible; and, in any case, itneed not be done till the necessity for it has become apparent. The bowel may be at once opened and fixed to the edges ofthe wound; or, if there is no urgency, it may be fixed, and theopening delayed for a few days till the wound has united andthe bowel has become adherent in its new situation. Delay inopening the bowel greatly diminishes the risk of unhealthyaction in the wound, and permits the employment of antiseptictreatment. On the other hand, if there is obstruction, the bowelmus
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