Preparatory and after treatment in operative cases . ll cases where therectus is sectioned two weeks in bed should be the rule. Muchunnecessary distress and, indeed, much adverse criticism of thescience of surgery will be obviated if this is a common practice. If primary union does not occur and the abdominal woundheal by granulation, the patient should be kept in the recumbentor semi-recumbent position until firm union of the muscular layerof the abdomen is attained. This requires several weeks in someinstances. As soon, however, as the muscles are healed the pa-tient may be permitted to leav
Preparatory and after treatment in operative cases . ll cases where therectus is sectioned two weeks in bed should be the rule. Muchunnecessary distress and, indeed, much adverse criticism of thescience of surgery will be obviated if this is a common practice. If primary union does not occur and the abdominal woundheal by granulation, the patient should be kept in the recumbentor semi-recumbent position until firm union of the muscular layerof the abdomen is attained. This requires several weeks in someinstances. As soon, however, as the muscles are healed the pa-tient may be permitted to leave the bed, even though completecicatrization of the skin has not taken place. This is justified by 448 OPERATIONS ON THE ABDOMEN the fact that the skin plays no part in retention of the abdominalcontents. When the patient is permitted to sit up or walk about, the ab-domen should be firmly supported with an abdominal binderwhich is applied while the patient is still in the recumbent posi-tion, and the binder should be fastened from below upward. The. Fig. 290.—Granulating Wound Ready for Secondary Suturing. wearing of belts and corsets following celiotomy is taken up undera separate head (page 475). The removal of sutures after celiotomy depends upon the ques-tion of drainage and infection. In cases in which the wound hasbeen closed up entirely, the sutures are left in situ until the tenthday. Of course, when catgut has been used, the sutures need notBe removed unless the portion of the suture material buried be-neath the skin is not absorbed at the end of the ten days. The use THE AFTER-TREATMENT FOLLOWING CELIOTOMY 449 of catgut in the skin is, as already stated, inadvisable and, indeed,but little employed. The silk-worm gut sutures are removed onthe tenth day, provided there be no indication for their earlierremoval. In many instances it will be found possible to leave en-tirely undisturbed the celiotomy wound until the time for remov-ing the sutures arrives. The method of
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