Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . h bowel end is about mm. (%ginch) long (Fig. 1309). The two bowel ends are folded back upon the mesentery, and a sutureintroduced at one side of the mesenteric angle, apposing serosa to serosa. Itis tied on the serosa side, and its end left long to serve as the first tractionguide. Another suture is then introduced through all the coats, the samedistance from the mesenteric angle as the previous suture, apposing serosa toserosa. It is not tied, but the ends ar
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . h bowel end is about mm. (%ginch) long (Fig. 1309). The two bowel ends are folded back upon the mesentery, and a sutureintroduced at one side of the mesenteric angle, apposing serosa to serosa. Itis tied on the serosa side, and its end left long to serve as the first tractionguide. Another suture is then introduced through all the coats, the samedistance from the mesenteric angle as the previous suture, apposing serosa toserosa. It is not tied, but the ends are left long, to be used as a second trac-tion guide. The distance between the first and second guides should beabout one-third of the circumference of the bowel. The two guides are then used for gentle traction in the hands of an assist-ant, bringing the wound edges in a line. The needle end of the firstguide is employed to make a continuous suture between the two (Fig. 1310).When the second traction guide is reached, a third traction guide is intro-duced, in a manner similar to the second, midway between the two first guides. Fig. 1309-—First Stitch in End-to-end is the mattress mesenteric stitch. The stitch is then continued between the second and third guides. Thesecond guide is then removed, and the last third of the suture completed byusing the first and second guides for traction alignment. The last part ofthis suture, of course, cannot be drawn tightly until all of the stitches havebeen introduced (Fig. 1311). The last stitch ends on the outside, and thesuture is tied to the end left as the first traction guide. The third guide isremoved and the ends of the last knot cut. Some surgeons prefer to tie thefirst traction suture on the inside, and end the suture by a knot which sinksinto the lumen of the bowel as the last suture is tied. In applying such a continuous suture, it should be interrupted at shortintervals or several separate sutures used. This i
Size: 1778px × 1405px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
