bowel sutures. 



113 



Czemy reinforced Lembert's stitch by interrupted sutures uniting 

 the mucous membrane, Lembert's stitch being employed to bring 

 the serous surfaces into apposition ; he thus unites the edges of the 

 wounds twice. The first series do not penetrate deeper than the 

 submucous tissue. This system, however, is difficult to carry out. 

 It is much easier if the suture begins and ends in the serous coat ; 

 the knots then lie externally between the two surfaces of peritoneum. 

 In isolated instances it may be desirable to unite the mucous 



Fig. 149. — Schema of Jobert' 

 (now abandoned). 



suture 



Fig. 150.— Schema showing 

 Jobert's suture in section. 



membrane itself. In such cases the first half or more of the incision 

 should be sutured from within, and the knots tied on the inner surface. 

 As, however, the wound becomes smaller this is no longer possible, 

 and the remaining half of the wound must be united with sutures 

 penetrating to the submucous coat but tied externally. The whole 

 of the wound having thus been closed, the serous surfaces are brought 



Fig. 151. — Lembert's bowel stitch. 



152 — Lembert-Czerny bowel stitch. 



together in the manner above indicated. It might be advisable in 

 cases where other tissues lined with mucous membrane are divided, 

 as for instance the eyelids, cheeks, salivary or urinary ducts, the 

 oesophagus or bladder, to proceed as above, uniting mucous membrane 

 to mucous membrane. The apposition of secreting surfaces should, 

 however, be avoided. 



Artery sutures are very seldom required in veterinary practice, 

 though small longitudinal wounds of arteries have been successfully 



