The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ening it by pressure between the handles of the scis-sors. Silk, however, should be cut squarely across, lest itsstrands unravel on attempting to pass it through the sutures are apt to slip out of the needle unless fastenedto it with a single knot. Silkworm-gut is secured by twist-ing it several times, or more correctly, by twisting the needleon its long axis while holding the loop of silkworm-gutsteady. Silver wire is prevented from slipping out of the Sutures. 119 needle by flattening the s
The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ening it by pressure between the handles of the scis-sors. Silk, however, should be cut squarely across, lest itsstrands unravel on attempting to pass it through the sutures are apt to slip out of the needle unless fastenedto it with a single knot. Silkworm-gut is secured by twist-ing it several times, or more correctly, by twisting the needleon its long axis while holding the loop of silkworm-gutsteady. Silver wire is prevented from slipping out of the Sutures. 119 needle by flattening the short and long end together and,if necessary, by twisting them slightly on each other. Button sutures, used after breast amputations or laparo-tomies, when there is great tension to be overcome, are to beprepared by mounting on stout silk, or on one or two strandsof silkworm-gut, a piece of block tin about a half inchsquare, and a large lead shot, both perforated. The cornersof the tin are trimmed to protect the skin, for which accountthe sharp edges of the button should also be turned up. Fig. 30. Twisting silkworm-gut suture. (towards the shot). After the button the shot is slipped onthe suture, and clamped about a quarter of an inch from theend by compression with a needle-holder or other heavy in-strument. Instead of the tin and shot, an ordinary bone orchina button may be used, two strands of silk or silkworm-gutbeing passed through its holes and tied together on its con-pave surface. Buttons of all kinds are apt to cause pressure 120 The Surgical Assistant. necrosis of the skin; for them may be substituted small rollsof gauze or pieces of rubber tubing, over which the sutureends are tied (quilled sutures). When handmg a suture to the operator the needle shouldbe grasped near its eye in the holder, the point of the needleshould be to the operators left and its concavity towards a reversed suture is to be passed the position of theneedle in the holder is to be rever
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1905
