BLUNT DISSECTION, 



165 



growths as spread by. the lymphatics, inasmuch as extirpation is incom- 

 plete and secondary tumours soon grow. 



For blunt dissection the end of a director or a small spatula may 

 be used. The movement is of a stabbing or thrusting character, the 

 point tearing through the connective tissue and isolating the part 



Fig. 1S9. — Liijating an aitery, firbt stage. 



without danger of haemorrhage. This method is excellent when ope- 

 rating in dangerous regions. It is particularly useful for isolating 

 vessels, as in ligaturing the jugular vein or carotid artery, and in 

 neurectomy. The wounds produced by blunt dissection heal almost as 

 quickly as those made with the knife. Different methods of ligation 

 are often employed to cause sloughing of tumours, organs or portions 

 of organs, like the vagina and uterus, and thus ensure bloodless removal 

 The most generally useful is the elastic ligature. 



Fig. 190. — Ligating an artery; second stage. 



When arterioles, small veins, or vessels of larger size are divided, 

 bleeding can only be checked by compression, packing the wound, 

 cauterisation (already noticed), ligation, torsion, or forcipressure. 



Compression is useful where one cannot stop to ligate the divided 

 vessel. The portion of the wound where the divided vessel is seated is 



