Preparatory and after treatment in operative cases . nage 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 ear
Preparatory and after treatment in operative cases . nage 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 removal of sutures is al-ready described (page 304, et seq.). If there be infection of thesuperficial wound, it should be treated in the manner already de-scribed with respect to other situations of the body (page 305).If infection of the superficial wound occurs after celiotomy,. Fig. 291.—Granulating Celiotomy Wound Approximated with Adhesive Plas-ter Strips. Rubber Tissue Drain in situ. healing by granulation is an exceedingly tedious process, requir-ing change of dressings every forty-eight hours for several scar following healing by granulation in this situation is ofminor import in the male, but in certain cases the female patientobjects strongly to the destruction of a certain cosmetic effect pro-duced by a marred abdomen. In these instances the wound shouldbe treated by cleansing and light packing until it is clean, andit may then be quite approximated by deep silk-worm gut su-tures, which do not entirely approximate the lower angle of thewound. Fig. 290 shows a wound which cleaned up after three 450 OPERATIONS ON THE ABDOMEN weeks of care, and now presents a condition favorable to second-ary approximation. The patient at times objects to narcosis and, indeed, to the in-jection of cocain s
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