ACCIDENTAL AND OPERATION WOUNDS 



55 



b}- passing interrupted sutures about a tenth of an inch apart, 

 and the same distance from the edges of the wound, through 

 the serous, muscular, and submucous coats only, great care 

 being taken to avoid puncturing the internal or mucous coat, 

 and to tuck the edges in, so as to bring the two serous surfaces 

 well into contact with one another. Small round milliner's 

 needles are the best ones to use when inserting these sutures ; 

 if a flat or bayonet-pointed needle is used the sutures are apt 

 to tear out. The object is to arrange the in-contact surfaces 

 A B c D 



t-' t. 



Interrupted Simple Continu- 

 Sutures. ous Suture. 



Furrier's 

 Suture. 



Halsted's 

 Suture. 



Lembert's Bowel Suture. 

 Fig. 33. — Different Patterns of Sutures. 



SO that the two edges to be sutured together consist only of 

 serous membrane. Adhesions with the surrounding parts are 

 not then so likely to form, and union is rapid. Particular 

 care must be taken to do this carefully ; if any fluid escapes 

 from the intestine into the abdomen peritonitis is sure to 

 ensue. 



In the case of a long incision there is always a little 

 ' pucker ' at each end which must be carefully sutured over, 

 and in closing a small circular aperture, the ' dra\\'-string ' or 

 ' tobacco-pouch ' pattern, \\hich passes in and out and around 



