Operative surgery, for students and practitioners . placed well beyond the outermost limits of thepart which is to be excised. These sutures are tied before thediseased portion is excised. A long piece of catgut, double, is usedfor the sutures, which are introduced with a long, straight orcurved, blunt-pointed needle. After the sutures have been intro-duced the loops are cut, making a corresponding number of indi-vidual sutures. The sutures are tied very slowly and not sufficientlytightly to cut through. OPERATIONS UPON THE LIVER. 497 According to the plan of Payr and Martina, the hemorrhagema
Operative surgery, for students and practitioners . placed well beyond the outermost limits of thepart which is to be excised. These sutures are tied before thediseased portion is excised. A long piece of catgut, double, is usedfor the sutures, which are introduced with a long, straight orcurved, blunt-pointed needle. After the sutures have been intro-duced the loops are cut, making a corresponding number of indi-vidual sutures. The sutures are tied very slowly and not sufficientlytightly to cut through. OPERATIONS UPON THE LIVER. 497 According to the plan of Payr and Martina, the hemorrhagemay be controlled and the walls of the defect, which is left afterexcision of the diseased portion of liver, approximated by the useof penetrating mattress sntures which are supported by being car-ried through perforated magnesium plates. The plates are placedon either side of the edges of the defect which is left in the liverafter the diseased portion has been removed. The sutures whendrawn tight exert a distributed compression and serve to control. Fig. 22S.—The Kousnetzoff and Pensky Suture. For control of hemor-rhage from the liver. The loops A and B of the sutures are cut to makethe separate ligatures which are tied alternately upon the upper and lowersurface of the liver. The A loops are cut upon the upper surface and theB loops upon the lower. The blunt-pointed needles for passing the suturesare shown in the upper part of the picture. the hemorrhage and approximate the edges of the wound. Inexcising the diseased portion of liver the section can be madewedge shape by cutting into the liver tissue so that the upper andlower edges of the remaining raw space in the liver are overhangingand can be brought together with suture and thus do away withthe raw surface that would otherwise remain. The plates may beapplied and sutures introduced before excising the diseased plates are placed opposite each other upon the upper and lower 498 ABDOMEN AND BACK. surfaces of th
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
