Operative surgery, for students and practitioners . e mucous mem-brane and the serous coats. Each suture is applied from within thegut, so that, when tied, the knot will be upon the inner, mucousmembrane aspect of the gut. As each of these four tractor suturesis passed, it is immediately tied and one end cut short, leaving the 428 ABDOMEN AND BACK. other end long. In tying, the sutures should be tied rather looselyso that after^vard they may be readily removed. In one or the other segment of the gut, a longitudinal incisionis then made. This incision is placed opposite the mesenteric bor-der,
Operative surgery, for students and practitioners . e mucous mem-brane and the serous coats. Each suture is applied from within thegut, so that, when tied, the knot will be upon the inner, mucousmembrane aspect of the gut. As each of these four tractor suturesis passed, it is immediately tied and one end cut short, leaving the 428 ABDOMEN AND BACK. other end long. In tying, the sutures should be tied rather looselyso that after^vard they may be readily removed. In one or the other segment of the gut, a longitudinal incisionis then made. This incision is placed opposite the mesenteric bor-der, should be about one inch long, and commences about one andone-half inches distant from the cut edge of the gut. Throughthis incision a narrow artery forceps is passed into the gut and thetails of the four tractor sutures seized and pulled through, thusdrawing the ends of the gut after them, with the result that theone segment of gut is invaginated into the other, their serous sur-faces lying in contact with each other and their corresponding edges. Fig. 198.—End-to-End Anastomosis (Mounsell). The four tractor sutureshave been introduced, the ends seized with a forceps passed through an incisionin one segment of the gut. in apposition all around. The four tractor sutures are held byassistants and put somewhat upon the stretch and then the corre-sponding edges of both segments of the gut are ready to be joinedby suture. The edges are sewed together with a through-and-throughstitch, using a straight needle and chromic catgut. This sutureshould be applied about one-quarter inch below the edges of thegut so as to leave a margin that wide between the suture line andthe edges of the gut. The stitches should be placed quite closetogether (intervals of one-eighth inch between the needle punctures)and each stitch should be drawn fairly tight. In order to avoid apuckering or purse-string^ effect in the suture a ^Dack-stitch shouldbe taken every fourth or fifth puncture. After the edges
Size: 1889px × 1323px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
