The surgical assistant, a manual for students, practitioners, hospital internes and nurses . Fig. 51. Coaptation of edges by traction with two forceps. first one in an assistants hand until all the sutures of thatrow are in place. The adaptation of edges during the intro- Suturing. 143 duction of a continuous suture is maintained by the assistantby holding taut the proximal (loose) end of the thread nearits emergence from the tissues,—releasing it, to secure a newhold, as the next suture is drawn down upon the line of union(Fig. 52). The final knot of a continuous suture is madeby leaving the
The surgical assistant, a manual for students, practitioners, hospital internes and nurses . Fig. 51. Coaptation of edges by traction with two forceps. first one in an assistants hand until all the sutures of thatrow are in place. The adaptation of edges during the intro- Suturing. 143 duction of a continuous suture is maintained by the assistantby holding taut the proximal (loose) end of the thread nearits emergence from the tissues,—releasing it, to secure a newhold, as the next suture is drawn down upon the line of union(Fig. 52). The final knot of a continuous suture is madeby leaving the last loop only partly drawn through and tyingto it the emergent end of the suture, still attached to theneedle; or, by drawing the final loop tightly but double, thefree end on one side being then tied to the double (needle). Fig. 53. Assistants manipulations during introduction of continuous suture. end on the other. When the suture has been secured the endsshould be cut short and the needle replaced upon the instru-ment table or left elsewhere within plain view. Skin edgesmay frequently be sufficiently adapted during suturing, witha single pair of forceps (Fig. 53), and looser folds of skinmay be pinched together by the assistants fingers, at eachend of the wound, a continuous suture holding well enoughin place when there is no tension. To prevent inversion and overlapping, skin edges shouldbe carefully coaptated by the assistant. This is to be done bymeans of mouse-tooth forceps, everting the edges of thewound as they are brought together (Fig. 54). It shouldbe remembered by the assistant, when he applies sutures him-self, that the further from the edges they are inserted themore the latter are inverted; and that by shifting the inser- 144 The Surgical Assistant. tion to the skin edge itself, or far fro
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1905
