The closure of laparotomy wounds as practised in Germany and Austria : including detailed methods and views communicated by over fifty leading surgeons / ed. and tr. by Walter H. Swaffield.

Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: The closure of laparotomy wounds as practised in Germany and Austria : including detailed methods and views communicated by over fifty leading surgeons / ed. and tr. by Walter H. Swaffield. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    Prof. OlsJicmsen, of Berlin. In reply to your inquiry I herewith inform you how I perform the closing suture after laparotomy. I suture with catgut only, the fact of its being sterile being ascertained from time to time by attempting cultures. The raw catgut is treated for thirty to sixty minutes with Carbol-alkohol at 70° C. and then preserved in absolute alcohol. Continuous sutures are inserted in four layers : (1) peritoneum, (2) fascia, (3) subcutaneous con- nective tissue, (4) skin. Fairly thin catgut is taken, especially for the skin; only for the fascia is a thicker sort used. Exceptionall}^ only are the recti brought together with two or three separate sutures. Before putting in the skin sutures the edges of the skin are rubbed with absolute alcohol; otherwise no antiseptic is brought into contact with the wound edges. Only when pus has soiled them I wipe them over with 1 in 500 corrosive; and further, when tuberculous ascites is present I rub into the wound some iodoform emulsion. After closure of the entire incision xeroform is shaken over it and rubbed into the suture holes, and over this sterile gauze and cotton-wool are applied. After ten to twelve days the dressing is re- moved and fresh sterile gauze used, which, like the first dressing, is fixed with broad plaster