METHODS OF UNITING WOUNDS. 



^35 



Fig. 155. — Needle-hoider 1 Reiner's). 



lating surfaces and effect healing. Furthermore, bruised or torn wounds 

 were not sutured, though even they may heal by primary intention, 

 provided the margins are not absolutely crushed, have not lost 

 their vitality, and have not been cut off from the circulation. 

 Tissues in which the circulation has been reduced to an absolute 

 minimum may still retain their vitality by means of the "plasmatic'" 

 infiltration until circulation of blood by"the formation of new blood- 

 \-essels becomes pos- 

 sible; and small frag- 

 ments of dead tissue 

 can be cast off \\ith- 

 out imperilling primar\- 

 union. 



Deep wounds were 

 left open because reten- 

 tion of discharges was 

 feared. By using drain- 

 age - tubes, however, 

 these can nowadays be 

 united without bad con- 

 sequences. On the other hand, great tension, especiall}' in wounds 

 with loss of substance, contra-indicates the use of sutures, which 

 would rapidly cut out, and would therefore only be a drawback. 

 Moreover, those portions of the lips of the wounds enclosed within the 

 threads might themselves die, increasing the loss of substance. 



It is inadvisable to remove irregular fragments from the edge of 

 the wound — to " regu- 

 late " the wound, as 

 the old school had it, — 

 because although the 

 lips thus more closely ap- 

 proximate to a straight 

 line, sound tissue may 



156. — Showing method of using needle-holder. 



Fig. 157. — Needle-holder (Hagedorn's) 



be removed, the wound is enlarged, and the tension on the sutures 

 must be increased. 



Sutures are therefore only contra-indicated when marked tension 

 exists, or when the wound shows septic infection or is offensive. 

 Almost all wounds in animals are more or less infected, but by the 

 free use of antiseptics such infection may be reduced to a minimum. 



For suturing wounds we require needles and various kinds of 

 suture material. Needles are either simple or provided with a 

 handle, and may be straight or curved ; some of the latter again 



