. Minor and operative surgery, including bandaging . uretogether, and repeats this procedure until the growth hasbeen strangulated in four sections. Subcutaneous Ligature.—This is applied by intro-ducing a needle armed with a ligature through the skinnear the growth, and carrying it through the subcutaneoustissues around the part to be constricted for a short distance,then bringing it out through the skin. The needle is againintroduced through the same puncture, and is again broughtout through the skin at some distance from the first pointof exit. It is next introduced through this puncture an
. Minor and operative surgery, including bandaging . uretogether, and repeats this procedure until the growth hasbeen strangulated in four sections. Subcutaneous Ligature.—This is applied by intro-ducing a needle armed with a ligature through the skinnear the growth, and carrying it through the subcutaneoustissues around the part to be constricted for a short distance,then bringing it out through the skin. The needle is againintroduced through the same puncture, and is again broughtout through the skin at some distance from the first pointof exit. It is next introduced through this puncture andbrought out at a more distant point. In this way thegrowth is completely encircled by a subcutaneous ligature, 236 MINOR SURGERY. which is finally brought out at the point of entrance ; thetumor is strangulated by firmly tying together the ends ofthe ligature (Fig. 205). If a needle armed with a double ligature is first passedunder the growth, the ligature is divided, and by passingeach end of the divided ligature subcutaneously around Fig. Method of applying subcutaneous ligature. (Holmes.) the growth it may be strangulated subcutaneously in twosections. Erichsens Ligature.—This ligature is employed tostrangulate tumors of irregular shape in a number of sec-tions. A strong silk or hemp ligature three yards inlength, one-half of which is stained black, is carried by aneedle as a double ligature under the growth at variouspoints so as to leave a series of loops about nine incheslong on each side of the tumor (Fig. 206) ; the black loopsbeing cut on one side, the white on the other, the ends arethen firmly tied so as to strangulate the growth in sections(Fig. 207). Elastic Ligatures.—Ligatures made of India-rubbervarying from half a line to several lines in thickness areoften made use of in surgery. They may be employedto strangulate growths such as moles or nsevi, or in thetreatment of fistula?, and are especially useful in the treat- ELASTIC LIGATURES. 237 ment of
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