Medical and surgical report of the Presbyterian Hospital in the City of New York . the bottom of the recto-vesical or Douglas pouch, itsupper end projecting from the lower part of the abdominal the patient is in Fowlers position this drain drains all of theabdominal pockets except one (X). (b) The Drain to the Stump Area.—This is made in a similar way,the piece of gauze used being about 12X3 inches, and the rubber tissue10 X 2 inches. When rolled up this drain is about the thickness of anordinary cigarette. The lower end of this drain is passed down to theappendix stump, its upper e
Medical and surgical report of the Presbyterian Hospital in the City of New York . the bottom of the recto-vesical or Douglas pouch, itsupper end projecting from the lower part of the abdominal the patient is in Fowlers position this drain drains all of theabdominal pockets except one (X). (b) The Drain to the Stump Area.—This is made in a similar way,the piece of gauze used being about 12X3 inches, and the rubber tissue10 X 2 inches. When rolled up this drain is about the thickness of anordinary cigarette. The lower end of this drain is passed down to theappendix stump, its upper end issuing usually at about the middleof the abdominal wound. When the patient is in Fowlers positionthis drain drains the pocket marked X, as shown on the followingillustration. SEPTIC PERITONITIS FROM APPENDICITIS. 123 The administration of the anaesthetic is discontinued as soon asthe drains are placed and the peritoneal edges of the wound apposed,for the closure of the abdominal incision can usually be completedbefore the patient comes out. The various layers are sewed up. Illustration showing the properly constructed pelvic and stump drains andan improperly constructed drain. A and B are the pelvic and stump drains before introduction. A and B are the pelvic and stump drains after introduction and transfixed bysafety-pin on skin level, and their upper ends unrolled into the dressing. X is made up of the same amount of gauze and rubber tissue as A and A but isrolled too tight, the gauze at the lower end is fringy and projects too far. separately if the patients condition allows of it, if not, through-and-through sutures are used. A large safety-pin is now passed through each drain where it issuesfrom the abdominal wound, on a level with the skin, and the part ofthe drain distal to the safety-pin is completely unrolled, thereby allowing 124 SEPTIC PERITONITIS FROM APPENDICITIS. of a greater surface of contact between it and the abdominal dressing;the latter should consist
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Keywords: ., bookcentury1800, bookdecade1890, bookpublishernewyo, bookyear1896
