The surgical assistant, a manual for students, practitioners, hospital internes and nurses . be obliged to pushthe loop down with a finger or with an instrument. If it hasnot been thus necessary to hold the forceps up while the firstknot is tied, the assistant should seize it again immediatelythereafter, in order to remove it when the knot is it is useful, when working in a small space, toremove the clamp after the first knot is secured. While thee^ssistants left hand is thus occupied with the manipulatioti 138 The Surgical Assistant. of the hemostat, his right should hol
The surgical assistant, a manual for students, practitioners, hospital internes and nurses . be obliged to pushthe loop down with a finger or with an instrument. If it hasnot been thus necessary to hold the forceps up while the firstknot is tied, the assistant should seize it again immediatelythereafter, in order to remove it when the knot is it is useful, when working in a small space, toremove the clamp after the first knot is secured. While thee^ssistants left hand is thus occupied with the manipulatioti 138 The Surgical Assistant. of the hemostat, his right should hold in readiness a pair ofscissors to cut the ligature ends. Blunt-end scissors, curvedon the flat, are best adapted to this purpose. They should beheld, with the concavity of the curve uppermost, by the ter-minal phalanx of the thumb and the middle phalanx of thefourth (or third) finger. Downward pressure with thethumb and upward pressure with the fourth finger secureclose contact of the edges when cutting, while counter-pres-sure of the index finger over the lock steadies the Fig. 47. Manipulation of hemostat and scissors in the application of aligature. The fifth finger may be rested on the patients body to bal-ance the hand. The scissors are held slightly open while theligature is being tied, and when the surgeon lifts its freeends, the blades are made to surround them. With a quickmovement at the wrist the blades are to be carried downalong the strands and closed about a quarter of an inch fromthe knot. These manipulations, longer in the descriptionthan in the performance, secure speed as well as precision. The assistant is often called upon to apply ligatures him-self. The square, flat, or reef knot is formed bypassing one end of the ligature, e. g., that in the right hand,in front of and around the other end into the left hand, andtightening the first knot; then passing the same ligature endback from the left hand in front of and around the other end,as before
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1905
