Operative surgery . rs, d. Thumb forceps, e. Needle Tenaculum, g. Blunt retractor, h. Xeedles. i. Traction loop. _/. Silkworm Chromicized catj^ut. l. Silver wire, m, n. Broad and hooked retractors. ing to the operating room (page T), the preparation of the patient, of theassistants, and of the surgeon himself, should be carefully considered andmade to conform to the accepted standard of requirement of the time. Inthe event of the presence of visitors, those coming in close relation withthe patient should not have been in recent contact with infecting agents or 610 OPERATIVE S
Operative surgery . rs, d. Thumb forceps, e. Needle Tenaculum, g. Blunt retractor, h. Xeedles. i. Traction loop. _/. Silkworm Chromicized catj^ut. l. Silver wire, m, n. Broad and hooked retractors. ing to the operating room (page T), the preparation of the patient, of theassistants, and of the surgeon himself, should be carefully considered andmade to conform to the accepted standard of requirement of the time. Inthe event of the presence of visitors, those coming in close relation withthe patient should not have been in recent contact with infecting agents or 610 OPERATIVE SURGERY. diseases, nor should they meddle with contiguous objects. A safe rule ofaction is to keep the hands in the pockets and avoid textile contact withothers unless properly clothed for the purpose. The Remarks.—The seat of the incision is determined usually by thelocation and outline of the morbid process to be treated. The length of theincision is a matter of great importance, for if too short, observation and. Fig. 7T6.—Arrangement of tissues corresponding to the upper three fourths of the rectusmuscle (above the semilunar fold of Douglas). manipulation by the surgeon are hindered, and the gravity of the procedureis enhanced because of the delay and damage arising from inadequate in-cision. If too large, needless exposure and escape of the abdominal contentswill happen. Both primary and exploratory excisions should be made shortat first, and be increased thereafter or changed in direction as circumstancesrequire. In long incisions Kelly prefers division through the umbilicus,avoiding the suspensory ligament. In closing the wound in these instanceshe splits the umbilical tissue at either side to afford broader surfaces forapproximation. Considerable time is taken by some operators in enteringthe abdomen, owing not infrequently to a want of confidence in their knowl-edge of anatomy and the fear of a precipitous entrance into the cavity. If,however, the primary incision b
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