. Annals of surgery. of the gut. (Fig. 2.) The twoends of the loosely-applied suture must be crossed at the place oftying or a little puckering will result, through which intestinal con-tents can pass. In Landerers first two cases a small faecal abscess 286 SURGICAL PROGRESS. formed at this place. It was shut off and did not interfere with re-covery. The suture need not be applied so near the end of the gutas is shown in Fig. 2, but more of the intestinal wall may be in-cluded. It may be inserted three to five centimetres from the begins this running suture at the point opposite
. Annals of surgery. of the gut. (Fig. 2.) The twoends of the loosely-applied suture must be crossed at the place oftying or a little puckering will result, through which intestinal con-tents can pass. In Landerers first two cases a small faecal abscess 286 SURGICAL PROGRESS. formed at this place. It was shut off and did not interfere with re-covery. The suture need not be applied so near the end of the gutas is shown in Fig. 2, but more of the intestinal wall may be in-cluded. It may be inserted three to five centimetres from the begins this running suture at the point opposite the inser-tion of the mesentery, and allows the threads to cross before the knot is made on the side towards the mesentery, irregularitiesare less easily discovered. With the help of this suture—as with thetobacco-pouch suture used with the Murphy button—the intestine ispushed over the cylinder so that it rolls into the groove, and thesuture drawn up like a shir-string and tied ; and its serous surfaces. Fig. 3. come together. In some cases it has sufficed to apply simply a singlesuture at the mesenteric insertion to prevent the gut from pullingapart. Healing in these cases was perfect. A few interrupted suturesor a running sero-serosa suture may be applied. These sutures areapplied very easily because the surfaces are held nicely in positionby the underlying cylinder. It suffices to apply simply a serosasuture at the mesenteric insertion and one on the opposite side ofthe intestine. The canal through the cylinder should be five to eight milli-metres in diameter. In dogs, Landerer used a canal three to fourmillimetres in diameter. In dogs which were killed on the third orfourth day there was no faecal accumulation found either above or ABDOMEN. 287 below the cylinder, as has been often found in the cases Avhere Mur-phys button was employed. The faecal current evidently circulatedfreely through the cylinder. At the third or fourth day the cylinder was found to be ju
Size: 1775px × 1407px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
