134 



OPERATIVE TECHNIQUE. 



being curved throughout, and representing the segment of a circle 

 or elHpse, others half curved, only the anterior half being curved, 

 the posterior being straight. The last two are the most useful. 

 Some needles are curved in the plane of their greatest thickness 

 in order to ensure greater stiffness. They are, however, less easily 

 grasped and directed. In modern needles the point is almost 

 always lancet-shaped and double cutting. Numerous complicated 

 arrangements have been introduced to facilitate threading, but 

 have not met with much popularity. One of the most practical is 



shown in Fig. 158. Com- 

 pound or handled needles 

 are fixed in a handle and 

 carry the eye close behind 

 the point (Fig. 153). They 

 are passed through the edges 

 of the tissue until the eye 

 k is exposed, and then threaded 

 and withdrawn, bringing the 

 thread with them. When 

 using small or sharply cur\ed 

 needles, working in the 

 depths of a wound or sutur- 

 ing firm tissues, a needle- 

 holder (Figs. 155 to 157) 

 is almost indispensable. In 

 case of need a pair of dressing 

 forceps efficiently replaces the 

 special needle-holder. 



The chief suture materials 

 are aseptic silk, silkworm gut, 

 and catgut, none of which 

 impede healing. Catgut is 

 very useful, as it becomes 



Fig. 15S. — Suture needles. 



absorbed after a time, and therefore the stitches require no further 

 attention ; but sometimes this occurs very rapidly, with the result 

 of releasing still ununited portions of the wound and allowing the 

 lips to open. To overcome this difficulty, bichromatised catgut, which 

 onl}' dissolves very slowly, is emplo3'ed, but silk is preferable for all skin 

 wounds, and can even be used for abdominal operations, as if properly 

 sterilised it does not irritate and becomes encysted or disappears. A 

 number of difterent sizes must be provided of each of these materials. 

 Silkworm gut is very smooth, non-absorbent, and unirritating ; it is 



