. A manual of operative surgery . ame time thedressings next the wound are kept dry. 3. By Incision and Drainage car-ried out in Two Stages.—The pro-ceeding employed is precisely iden-tical with that already described inthe account of hydatids of the liver(page 135). The best method is thatemployed by Mr. Godlee. This willbe understood by reference to A double row of sutures ispassed through the rectus sheath andperitoneum on the one hand, and thesubjacent liver capsule and tissue onthe other. The outer row should beinterrupted sutures, the inner con-tinuous. It has been pointed out th
. A manual of operative surgery . ame time thedressings next the wound are kept dry. 3. By Incision and Drainage car-ried out in Two Stages.—The pro-ceeding employed is precisely iden-tical with that already described inthe account of hydatids of the liver(page 135). The best method is thatemployed by Mr. Godlee. This willbe understood by reference to A double row of sutures ispassed through the rectus sheath andperitoneum on the one hand, and thesubjacent liver capsule and tissue onthe other. The outer row should beinterrupted sutures, the inner con-tinuous. It has been pointed out that in dealing with the parasiticcyst, this method in two stages has no very great same observations may apply to the case of hepatic abscess. In addition to such objections as have been already formu-lated, the following may be noted :— The adhesions which form, when no sutures are employed,may be insignificant, and may cover but a very small the incision is made, that area may be easily transgressed,. FIG. 42.—METHOD OF ATTACH-ING THE LIVER TO THE PARIETES. (Goalee.) a, Subcutaneous fat ; b, Rectus ;c, Sheath of rectus ; d, Liver ;e, Interrupted suture ; f, Con-tinuous suture. 140 ABDOMINAL OPERATIONS [part ii Such adhesions cannot be firm until many days have elapsed,and this delay may prove a serious matter in the case of anabscess which is rapidly approaching the surface. Moreover,after adhesions have been secured, the abscess may show signsof pointing at another spot distant from the intended site ofthe incision. If Mr. Godlees method be adopted, these ob-jections cease for the most part to hold good. Mr. Godleehas shown that if the sutures are introduced in the mannerdescribed, the abscess may be at once opened, and all delaythus avoided. Observations and Comment.—The method by free incisionat one sitting offers undoubtedly the best means of dealing withhepatic abscess. Attempts to open the abscess by means ofthe actual cautery are to be c
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