Diseases of the ovaries : their diagnosis and treatment . 1, without anydepression of the abdominal wall, and the patient is quiteunconscious of its presence. Sometimes, with a very shortpedicle, the clamp and the integuments are drawn almost down 390 THE CICATRIX AFTER OVARIOTOMY. to the sacrum, even then, without much complaint from thepatient. There will sometimes be protrusion of the pediclebehind the clamp, separating the lower edges of the this occurs, the lowest stitch should be removed, as theprotrusion is due to obstructed return of blood through theveins of the pedicle. Tw
Diseases of the ovaries : their diagnosis and treatment . 1, without anydepression of the abdominal wall, and the patient is quiteunconscious of its presence. Sometimes, with a very shortpedicle, the clamp and the integuments are drawn almost down 390 THE CICATRIX AFTER OVARIOTOMY. to the sacrum, even then, without much complaint from thepatient. There will sometimes be protrusion of the pediclebehind the clamp, separating the lower edges of the this occurs, the lowest stitch should be removed, as theprotrusion is due to obstructed return of blood through theveins of the pedicle. Two or three times the protrusion hasbeen so great that I have passed a pin through the pediclebehind the clamp, tied a ligature below the pin, and cut awayboth clamp and pedicle ; but this is seldom necessary, as theswelling subsides soon after the removal of the compressioncaused by the too tight stitch. The clamp and the portion ofpedicle compressed by it generally fall off from the seventh tothe tenth day, sometimes as early as three or four days, and. sometimes not for fifteen or more. It is important not toremove the clamp too soon, especially if the pedicle is short, asthe newly-formed adhesions between the pedicle and the ab-dominal wall might give way, and the pedicle sink into theperitoneal cavity, leaving an opening which, after healing ofthe skin, would admit of the easy production of a ventral SYMPTOMS INDICATING PERITONEAL MISCHIEF. 391 hernia. But when the clamp is only held by a few shreds ofdead tissue, it may be removed. A little ulceration of integu-ment from pressure of the clamp should not lead to the pre-mature removal of the clamp, as this is of far less consequencethan the risk of removing the clamp too soon. The woodcuton the opposite page, copied from a photograph taken by , shows the ordinary appearance of the abdomen withthe cicatrix in a young person three weeks after operation. Where a clamp has not been used, but the patient has beentreated
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectgynecology, bookyear1
