Treatise on gynæcology : medical and surgical . ition of the j>arts to which tamponshave been applied. At all events, the pouch should not be taken outbefore the fifth day, so that the peripheric adhesions may become firmenough to be safe from all danger of tearing. It is easy enough toremove the strips of gauze, if you follow my advice and put on somemark by which they may be distinguished and removed in consecu-tive order. Otherwise their extraction may be difficult and cause 73 CLINICAL AND OPERATIVE GYNAECOLOGY, injury. Gluck has recently proposed the use of tampons which canbe absorbed
Treatise on gynæcology : medical and surgical . ition of the j>arts to which tamponshave been applied. At all events, the pouch should not be taken outbefore the fifth day, so that the peripheric adhesions may become firmenough to be safe from all danger of tearing. It is easy enough toremove the strips of gauze, if you follow my advice and put on somemark by which they may be distinguished and removed in consecu-tive order. Otherwise their extraction may be difficult and cause 73 CLINICAL AND OPERATIVE GYNAECOLOGY, injury. Gluck has recently proposed the use of tampons which canbe absorbed, as catgut, etc. This seems to me a theoretical idea in-capable of practical Though it be necessary to leavethe tampons in place long enough to permit of the formation ofplastic, aseptic inflammatory adhesions surrounding and circumscrib-ing it, it is self-evident that the external dressings should bechanged as often as necessary—or about three times a day. Theserum secreted at the depth of the wound and transmitted by capil-. Fig. 55.—Tamponade of the Peritoneal Cavity after Hysterectomy, a a, Pouch of iodofor gauze ;b, silk thread fastened to centre of pouch; c c, strips of iodoform gauze. lary drainage through the tampons is very rapidly absorbed by thisexternal dressing. It is no more possible to lay down an absolute rule in reference tocases demanding the use of tampons than it was in the case of drain-age. Much is necessarily left to the judgment of the operator. Tam-ponade should certainly be reserved for exceptional use, an ultimaratio, either for parenchymatous oozing (hemostatic tamponade) orin case of threatened septic infection (protective antiseptic tampon-ade). In the latter case, two different conditions may exist. METHODS OF SUTURE AND H^EMOSTASIS. 77 A. A part of the wound is already septic at the time of operation,and on account of the presence of septic tissue which cannot be re-moved without danger, or of the large effusion of pus and se
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