Identifier: amerbook00star (find matches)
Title: An American text-book of the diseases of children ..
Year: 1895 (1890s)
Authors: Starr, Louis, 1849-1925 Westcott, Thompson Seiser, 1862-
Subjects: Children
Publisher: Philadelphia, W.B. Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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avies-Colley, of Guys Hospital, commends itself. Figs. 20 and21 will convey his idea. Next, the introduction of the sutures, by far the most difficult part of theoperation. I prefer >ilk Butures, andconsider them much superior to silver wireand shot, as they are softer in the mouth, and seemingly do not produce thesame amount of irritation and annoyance to the child. Two colors, white andMack, Bhould he used, a- all the Btitchee Bhould be passed before tying, and ifthese color- alternate confusion of the ends need not occur. The well-curvedneedle, having been threaded, is introduced on one side (the patient beingrecumbent), from below upward, or what would be, if the patient were upright,from behind forward (Fig. 22). To facilitate passing the needle the flap is heldand drawn tense by forceps. The thread is then caught from the eye of theneedle by a blunt tenaculum (Fig. 22), one end drawn all the way through, andthe needle passed back and drawn oft the other end. FlG. 22. Fig. 23.
Text Appearing After Image:
End of suture, a, is next passed through loop, b,which is used only to draw end a through theflap of that side. Ends o and c are subsequentlytied. Passing a Suture. This procedure is easier than if the needle were previously passed in thereverse direction, as is usually recommended. Having passed the suture onone side, one must pass a double thread on the opposite side, drawing up inlike manner with a tenaculum the two free ends, which leaves the loop below(Fig. 23); the needle is then drawn back as before and disengaged. Thenthrough the loop is passed the lower end of the single suture, and, by meansof the double thread, it is pulled through the opposite side. In passing thestitches great care should be taken to engage sufficient tissue, not getting themtoo near the edge, and also to have them passed as nearly as possible at pointsopposite each other. Before tying the sutures special care should be observed to see that the edgesof the flaps are clean and free from clotted blood. Then

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