. American practice of surgery ; a complete system of the science and art of surgery . he wound,and before union has taken place between it and the abdominal wound, the SURGICAL DISEASES OF THE ANUS AND RECTUM. 941 organ may be clasijod with two i)airs of intestinal compression forceps, appliedabout an inch apart, and an incision th(>n made between them just large enoughto introduce the end of a Pauls tube* A piece of rubber drainage tubing isthen attached to the distal end of the glass tube to tlraw off th(^ gas and the tube has been secured in the bowel, the base of the protru
. American practice of surgery ; a complete system of the science and art of surgery . he wound,and before union has taken place between it and the abdominal wound, the SURGICAL DISEASES OF THE ANUS AND RECTUM. 941 organ may be clasijod with two i)airs of intestinal compression forceps, appliedabout an inch apart, and an incision th(>n made between them just large enoughto introduce the end of a Pauls tube* A piece of rubber drainage tubing isthen attached to the distal end of the glass tube to tlraw off th(^ gas and the tube has been secured in the bowel, the base of the protruding loop ofthe bowel should be sutured to the edges of the abdominal wound. If there isno urgent reason for the immediate opening of the bowel, it may remainclosed for several days. ^Yhen a temporary artificial anus is to be made, the following method shouldbe pursued:—A simple longitudinal incision is made from the superior angle ofthe wound to a point half an inch below the supporting rod. Tuttle recom-mends, in addition, that a transverse incision, involving two-thirds of the. Fig. 390.—Temporary Ingiiinal Colostomj. (Tuttle.) circumference of the bowel, be made at the lower end of this longitudinal incision.(Fig. 390.) In both instances the object is to preserve as much of the wall ofthe bowel as is possible, in order that it may be more easily restored. Tuttleclaims that, in making the transverse incision, the triangular flaps roll backwardand curl up, and, when the artificial anus is to be closed, the curls of the flapscan be dissected apart, unrolled, and sutured in their original places. In thelatter case, or when a permanent artificial anus is to be made, or if, after pro-viding for a temporary artificial anus, it becomes necessary to make it permanent,the entire circumference of the protruding loop of bowel can be cut through * Under the title of F. T. Pauls Method of Performing Colectomy there Trill be found, inthe British Medical Journal for May 25th, .1895, p.
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