Volume 1

Operative surgery / by Joseph D. Bryant.

  • Joseph D. Bryant
Date:
1900-1901
Catalogue details

Licence: In copyright

Credit: Operative surgery / by Joseph D. Bryant. Source: Wellcome Collection.

    91/624 (page 61)
    Fig. 86. Pin above vessel. Fig. 87. Oblique inser- tion of pin. Fig. 88. Pin beneath vessel. parts are transfixed by this rod at such a depth as to include the whole thickness of the proposed flap. A strong rubber cord is then passed over the extremities of the rod with sufficient force to compress the vessels in the tissues above it. The flap can then be made and the vessels ligatured without loss of blood, after which the rod is withdrawn and the remaining flap made in a similar manner. The preceding method illustrates the use of trans- verse elastic pressure as associated with the transfixion of a limited amount of the soft tissues by a sharp rod, for the purpose of securing bloodless operations. Somewhat recently Dr. Wyeth has brought forward a wise modification of this means, which consists of circular elastic compression of the entire limb associ- ated with pin or skewer transfixion of the soft parts, for the same purpose. This method is superior in all respects to the last two preceding ones, and which it has superseded. Since the details of the plan are di- rected to amputation at the hip, their description will appear under that title (page 483 et seq.). The Acupressure.—Acupressure for the control of haemorrhage was devised by Sir James Y. Simpson, and is used much less than formerly. It is applied in many ways ; the methods of the application may, how- ever, be reduced practically to two in number: one., where the pin is carried through the soft parts under KVi^ Fig. 85. Trendelenburg’s rod. the vessel, and the point elevated and pushed through at an angle sufficient to cause it to tightly close the lumen of the artery by pressing the vessel against the overlying tissues (Fig. 88). If this means be not effective, additional pressure can be made by passing beneath each extremity and obliquely above the pin several turns of cotton yarn or of the ordinary silk ligature. The other method is the reverse of the first, the pin resting upon and pressing the vessel downward upon the deep- seated tissue, instead of upward against the superficial (Figs. 86 and 87). Acupressure is often employed to arrest haemorrhage from small branches of