Operative surgery, for students and practitioners . ny danger of the loop ofbowel becoming displaced or retracting back into the abdomen. Thesutures A and B, and C and D are tied, thus closing the incision inpart and fixing the bowel in the upper and lower ends of the incision. This intramuscular method insures a fairly continent artificialanus. As the split muscles return to their natural position theygrip the protruding loop of bowel pretty tightly and thus close theartificial anal oj)ening. Fatty appendices hanging from the loop of bowel are ligatedand cut away. A layer of rubber tissue is
Operative surgery, for students and practitioners . ny danger of the loop ofbowel becoming displaced or retracting back into the abdomen. Thesutures A and B, and C and D are tied, thus closing the incision inpart and fixing the bowel in the upper and lower ends of the incision. This intramuscular method insures a fairly continent artificialanus. As the split muscles return to their natural position theygrip the protruding loop of bowel pretty tightly and thus close theartificial anal oj)ening. Fatty appendices hanging from the loop of bowel are ligatedand cut away. A layer of rubber tissue is placed over the bowel to prevent stick-ing of the dressings. The loop of bowel is opened by longitudinal incision with theknife or, better, with the cautery at a dull red heat after the lapseof several days, depending upon the urgency of the case. Whenthe bowel is opened it will be seen that there are two openingsseparated by a partition or spur that prevents the entrance of mate-rial into the loAA-er loop. OPERATIONS UPON THE LARGE INTESTINE. 469. Fig. 219.—Colostomy. Rubber tube fixed in the loop of intestinewith a purse-string suture. 470 ABDOMEN AND BACK. If necessary to open the bowel immediately this may be donewithout danger of soiling by inserting a thick rubber tube or aPaul glass tube into the bowel. The loop of gut is emptied bystripping with the fingers and a rubber-sheathed holding clampapplied to the bowel to prevent re-entrance of contents until thetube has been secured in place. A purse-string of silk is introducedin the wall of the bowel and a small incision made. A small amountof intestinal contents that escapes is caught with a gauze ^ rubber tube or Pauls tube is introduced into the bowel andsecured by tying the purse-string moderately tight around it.
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
