Text book of abdominal surgery : a clinical manual for practitioners and students . nclusion ofthe mucous membrane. The first stitch makes a pucker of theperitoneum, and is tied. The peritoneum is then picked upon one side, and a little nearer the cut on the other, to makethe second stitch; the next will probably begin to draw thecut edges together, the needle being inserted about a quarterof an inch or rather less from the cut edge, and brought outnearly at the edge on one side; on the other side the directionis reversed, the needle is inserted close to the edge, and broughtout a quarter of a
Text book of abdominal surgery : a clinical manual for practitioners and students . nclusion ofthe mucous membrane. The first stitch makes a pucker of theperitoneum, and is tied. The peritoneum is then picked upon one side, and a little nearer the cut on the other, to makethe second stitch; the next will probably begin to draw thecut edges together, the needle being inserted about a quarterof an inch or rather less from the cut edge, and brought outnearly at the edge on one side; on the other side the directionis reversed, the needle is inserted close to the edge, and broughtout a quarter of an inch away from it. This is in principle,though not actually, the Lembert mode of stitching. It thenzigzags in this way across the whole length of the wound, and 122 THE STOMACH. finishes as it began, a quarter of an inch beyond the end ofthe opening. Somewhere about eight stitches are required tothe inch; the peritoneal surfaces are drawn together as thestitching is gone on with, and every care must be taken againstdrawing the surfaces too tightly together. Additional stitches. Fig. 15.—Continuous Suture of Stomach. may be required if there seem to be any weakness at anypoint; these may be interrupted ones, and are also passed soas to double in the peritoneum; or a second doubling in ofthe peritoneum may be effected by another continuous row ofstitches. Some prefer to use the interrupted sutures entirely;the principle is exactly the same, the peritoneum being turned
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectabdomen, bookyear1894
