Operative surgery . ning (Figs. 1181, 118^,and 1183). Fistulas varymuch in their extent andrelation to the gut. Thehorseshoe (Fig. 1184) vari-ety has an opening withinand one at either side of theanus without, a sinus com-munication existing be-tween the outer openings,and both communicatingwith the inner one (). The internal sinusshould be slit up by an in-cision which emerges at theskin margin at a point equi-distant between the twoother openings if curved sinus is thendivided in either directionto the openings without in-volvement of the gut (). Only one divisio
Operative surgery . ning (Figs. 1181, 118^,and 1183). Fistulas varymuch in their extent andrelation to the gut. Thehorseshoe (Fig. 1184) vari-ety has an opening withinand one at either side of theanus without, a sinus com-munication existing be-tween the outer openings,and both communicatingwith the inner one (). The internal sinusshould be slit up by an in-cision which emerges at theskin margin at a point equi-distant between the twoother openings if curved sinus is thendivided in either directionto the openings without in-volvement of the gut (). Only one divisioninto the gut should be made,unless more than one open-ing be present there, andthe openings be independ-ent of each other. Direct Incision withClosure (S. Smith).—If theextent of the sinus will per-mit it, the entire tractshould be removed by dis-section and the resultingwound closed by catgut sutures carried deep enough to bring the walls ofthe wound in contact with each other. Two rows of chromicized catgut su-. FiG. 1185.—Fistula in ano, equilateral horseshoe formLine of incision.
Size: 1954px × 1279px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
