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Annals of surgery . he surgeon and not, open methods excluded, upon theparticular method. Our patients are kept upon their backs fortwenty-one days. Wounds thoroughly healed throughout perprimam arc not strong in eight days. One can easily tear opena typically healed wound which is not more than six or sevendays old. Not long ago, in attempting to restore a club foot toits proper position, I accidentally and with very little force, pressedwide open a wound which had healed in the typical way, and waseight days old. A wound is certainly stronger on the fourteenth day than itis on the seventh, a
Annals of surgery . he surgeon and not, open methods excluded, upon theparticular method. Our patients are kept upon their backs fortwenty-one days. Wounds thoroughly healed throughout perprimam arc not strong in eight days. One can easily tear opena typically healed wound which is not more than six or sevendays old. Not long ago, in attempting to restore a club foot toits proper position, I accidentally and with very little force, pressedwide open a wound which had healed in the typical way, and waseight days old. A wound is certainly stronger on the fourteenth day than itis on the seventh, and stronger on the twenty-first day than onthe fourteenth. Just how long wounds of skin and muscle whichhave healed by first intention may continue to increase in strengthwe do not know. In our hernia wounds, the subcutaneous ridgeof the aponeurosis and muscle which results when the parts havebeen brought together properly by buried mattress stitches doesnol disappear entirely for five or six or more weeks. I .some-. Fig. r. [nguina] canal laid open; sac cut away after suture of the peritonaeum; ele ments of cord isolated and lifted up; deep mattress sutures introduced. ^.—Aponeurosis oi th< external oblique S.—Buried skin-stitch, introduced but not muscle. tied. D— Vas di i -. T. I onjoined tendon. F.—Fascia transversalis. V.—^ em. /.—Peritonaeum. Stumps of excised veins. 5.—Buried -Kin stitch, tied. RADICAL CURE OF INGUINAL HERNIA. 547 times question the propriety of allowing, as I do, my patients towalk about on the twenty-first day. The technique of operations for the radical cure of herniashould be usually perfect, because we have to violate occasion-all}- what I consider to be one of the most important principlesof antiseptic surgery. We have to constrict the tissues some-what with our deep sutures. It is not always possible to bringtogether the pillars of the external abdominal ring without alittle tension. One can, of course, make relaxation cuts,
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885