Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . longitudinal bands of the bowel about 5 or 6 cm. from the end. This 644 5 URGICA L TREA TMEN T may then be united with the ileum, making an end-to-side anastomosis (seeAnastomosis with Button, page 667). Or an end-to-end anastomosismay be done. The peritoneum should be sewed over the raw surface inthe back of the abdomen. To prevent obstruction, to the passage of gas is a most important considera-tion in connection with these operations on the colon. The great dan
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . longitudinal bands of the bowel about 5 or 6 cm. from the end. This 644 5 URGICA L TREA TMEN T may then be united with the ileum, making an end-to-side anastomosis (seeAnastomosis with Button, page 667). Or an end-to-end anastomosismay be done. The peritoneum should be sewed over the raw surface inthe back of the abdomen. To prevent obstruction, to the passage of gas is a most important considera-tion in connection with these operations on the colon. The great danger isperitonitis from yielding of the sutures because of gas distention of the bowel,which is apt to be pronounced between the fourth and sixth days. To obvi-ate this, after resection such as is described above, the stump of the colonis brought up to the anterior abdominal wound by a couple of silkworm-gutsutures which hold the wound at the closed end of the bowel, against therectus muscle. The parietal peritoneum is not permitted to intervene. Theends of the purse-string suture should be left long and lie free in the wound. Fig. 1304.—Safety Operation to Insure against Obstruction after Resection of end of the bowel has been closed with a purse-string suture. Two sutures arepassed on either side of this and through the abdominal wall to hold the place of closureagainst the abdominal wound. The ends of the purse-string suture are brought out throughthe wound to guarantee drainage, as suggested by Mayo. as a guide. A strip of gauze is passed down to the puckered bowel wound(Fig. 1304J. This gives a communication to the bowel through the abdomi-nal wall. The ends of the purse-string suture lie beside the gauze andproject beyond the skin. The two sutures which hold the bowel againstthe abdominal wall are left long and are removed at the end of seven the colon becomes distended with gas, it is a simple matter to withdrawthe gauze, and pass a trocar and canula o
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
