A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . r part of the abdomen is of great assistanceto the operator. It is called the Trendelenburg position ; and maybe obtained by placing an inclined plane of wood under the hips andthighs, or by the use of a special form of operating table. By the toilet of the peritoneum is meant the removal of all blood 616 DISEASES OF THE ABDOMEN AND PELVIS. and other fluids by irrigation or by sponges pushed into the pelvic orlumbar fossae. This
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . r part of the abdomen is of great assistanceto the operator. It is called the Trendelenburg position ; and maybe obtained by placing an inclined plane of wood under the hips andthighs, or by the use of a special form of operating table. By the toilet of the peritoneum is meant the removal of all blood 616 DISEASES OF THE ABDOMEN AND PELVIS. and other fluids by irrigation or by sponges pushed into the pelvic orlumbar fossae. This may require them to be seized by long forceps,so as to give them a sort of handle. If the fluid is gelatinous orpurulent, it will be necessary to wash out the cavity with sterilizedwater or salt solution of a temperature of 105°, poured into the this means any unrecognized bleeding is discovered, because thewater returns stained, and shreds of tissue or lymph are effectivelyremoved. It is not necessary to insist upon the removal of all suchsterilized water which has been used to flush the cavity, because it isharmless and is soon absorbed. Fig. Patient in Trendelenburg position. (Davexport,) Whenever it is believed that a purulent cavity has not been perfectlycleansed and that purulent material remains, it becomes necessary toleave a drainage tube or gauze wick in the wound at the time of ad-justing the sutures. Healthy peritoneum absorbs aseptic fluids rapidly,but a diseased peritoneum does so very slowly. In such cases, andwhere there is very great transudation of fluid subsequent to operation,Douglass pouch and the fossee in the renal regions are the receptaclesin which such fluids accumulate; and disastrous inflammation is liableto occur because of the possibility of septic changes occurring there.
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