. St. Thomas's Hospital reports. ©€, the end ? will be brought through the opposite side of thefissure. It now only remains to pull through one side of thethread, when the appearance represented at b (fig. 16) isshown. AVhen sufficient threads, say three or four, have beenintroduced, the next step is to approximate the edges. A slipknot is perhaps the best; and before putting the end into thenoose, it is well for the surgeon to take the other end of thethread in a figure-of-8 form around his left forefinger and thumb,which manoeuvre prevents the thread from getting entangled, andthen it runs a
. St. Thomas's Hospital reports. ©€, the end ? will be brought through the opposite side of thefissure. It now only remains to pull through one side of thethread, when the appearance represented at b (fig. 16) isshown. AVhen sufficient threads, say three or four, have beenintroduced, the next step is to approximate the edges. A slipknot is perhaps the best; and before putting the end into thenoose, it is well for the surgeon to take the other end of thethread in a figure-of-8 form around his left forefinger and thumb,which manoeuvre prevents the thread from getting entangled, andthen it runs as easily as possible (fig«:lfi). Coloured threadsmay or may not be used. It is, I think, a good plan as the J 70 On Cleft Palate. operator procccfls to tie the ends of each succeeding thread ; andsupposing four sutures are employed, the practice I adopt is to Fig. give the first thread, or that nearest the hard palate, to anassistant, who holds it at the centre of the forehead; the secondis held over the patients ears, the third under the patients ears,and the fourth at the sides of the neck. Simple as this pro-ceeding may appear, it saves confusion to a marked extent, for•when the time arrives for drawing together the sutures, there isno difficulty whatever in selecting the corresponding a rule, I secure the stitches from above downwards. Theoperation is completed by either dividing the muscles, accord-ing to Sir W. Fergussons plan, before the sutures are closed, ifthis has not already been done, or by taking the tension off thestitches by making a vertical incision, as Dieffeubach did, abouta quarter of an inch in length on each side of the fissure. Whennecessary the anterior and posterior pillars of the fauces, withsome fibres of the palato-glossus and palato-pharyngeus, may bedivided. The accompanying woodcut (figs. 17, 18j show t
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Keywords: ., book, bookcentury1800, bookidstthomasshospita07stth, bookyear1836
