416 



HEALTH AND DISEASE 



of the strength last referred to for four or five days, and silk should be 

 treated in the same way, after first being boiled for twenty or thirty 

 minutes. By the adoption of this course, suppuration in the track of the 

 stitches is guarded against, and healing is facilitated. 



Fig. 413. Interrupted or Simple Suture 



SUTURES OR STITCHES 



Various kinds of sutures are employed for bringing together and secur- 

 ing the edges of wounds during healing. The materials used for this 



purpose are chiefly flexible wire, cat- 

 gut, silk, horse-hair, and silk-worm gut. 

 Sutures are either interrupted or 

 continuous. The interrupted variety 

 is perhaps the most commonly em- 

 ployed in veterinary practice, and too 

 frequently without due regard to the 

 nature of the wound and the prospect 

 of speedy union. 



Interrupted or Simple Sutures 



are used more especially for wounds of 



irregular shape, or situated in positions difficult of access or in which there 

 is tension. They are formed by threads passed from side to side through 

 the lips of the wound and separately tied. Fig. 413 gives an example 



of this suture, showing the knot as it 



should be, lying well to one side of 



the incision. 



Uninterrupted or Continuous 



Suture. - - This form of suture is 

 employed where the wound or in- 

 cision is superficial though extensive. 

 The blanket or button-hole stitch (fig. 

 414) is the one most to be preferred. 

 The stitch is commenced at one extremity of the wound, and after the 

 needle has been passed through the two lips it "is then carried under the 

 slack of the thread, so that the loop of each stitch after being tightened 

 shall be at right angles to the edge of the wound, while the portion inter- 

 vening between the stitches is parallel to it ". To fasten it off, the needle 

 is passed in the opposite direction through the edges of the incision, and 

 tied as shown in the diagram. In the employment of continuous sutures 

 care should be taken that the edges are perfectly coapted, and that no 

 puckering or wrinkling result from it. 



Fig. 414. Continuous Suture 



