Treatise on gynæcology : medical and surgical . ntinuous Su-ture (Musculo-aponeurotic Layer). meteorism or tumors, all the deep interrupted sutures should be madewith silk instead of catgut. 5. Quilled Sutures.—Small rolls of iodoform gaiize are now sub-stituted for the quills and lead plates in former use. Listers buttonsuture, with the heavy silver wire and piece of lead, has also beensuperseded by better processes. It is no longer used in perineorrha-phies, but there are some exceptional cases where it may be employed. METHODS OF SUTURE AND iLEMOSTASIS. 53 For instance,7 where a large abdom
Treatise on gynæcology : medical and surgical . ntinuous Su-ture (Musculo-aponeurotic Layer). meteorism or tumors, all the deep interrupted sutures should be madewith silk instead of catgut. 5. Quilled Sutures.—Small rolls of iodoform gaiize are now sub-stituted for the quills and lead plates in former use. Listers buttonsuture, with the heavy silver wire and piece of lead, has also beensuperseded by better processes. It is no longer used in perineorrha-phies, but there are some exceptional cases where it may be employed. METHODS OF SUTURE AND iLEMOSTASIS. 53 For instance,7 where a large abdominal tumor adheres anteriorly tothe parietal peritoneum, its removal will leave an extensive raw sur-face, caused by the stripping of the peritoneum from the internalabdominal wall. The liability to septicaemia is increased by the pres-ence of this large and moist surface. It will then be found useful, be-fore closing the abdomen, to carry a long, deep suture from one sideto the other, supporting it at each end with a roll of iodoform Tig. 33.—Suture of Abdominal Walls after Hysterectomy. Interrupted suture of the integuments and subcutaneous areolar tissues. This will fold the abdominal walls above and parallel to Poupartsligament; will exercise a beneficial pressure upon the raw surfaces,prevent hemorrhages and serous exudation, and thus eliminate onesource of infection. These sutures can be withdrawn in from five tosix days. Hcemoslasis.—We have compression for capillary hemorrhages;torsion for small arteries, suture for the surface of wounds. But thetwo methods to which I call especial attention are ligation and forci- 54 CLINICAL AND OPEEATIVE GYNAECOLOGY. pressure. I shall not touch upon ligation of the vessel alone, as it hasno especial bearing npon the subject in hand, but pass on to ligaturein mass, which is of superlative interest in gynaecology, and bymeans of which we are able to control the often formidable hemor-rhages of the pedicles of abdominal t
Size: 1270px × 1967px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubje, booksubjectgynecology
