ACCIDENTAL AND OPERATION WOUNDS 57 



in the suture of divided muscles and tendons. Care must be 

 taken that it is not drawn so tight as to \\rinkle the skin, or 

 heaUng will be retarded, and the cicatrix will be uneven and 

 prominent. 



The purse, draw-string-, or tobacco-pouch suture 

 is made by pressing a continuous suture through the tissues 

 in an ' in-and-out ' manner, like a draw-string is placed round 

 the neck of a purse or bag, the ends being then drawn tight 

 and tied. It is used under certain conditions to contract the 

 orifice of the anus, and in the intestine when performing an 

 anastomosis by means of Murphy's button. 



The needles (see Fig. 35) used for suture purposes are of 

 various sizes, shapes, and patterns. They may be straight. 



Fig. 35. — Wire Suture Needles (Reeks'). 



curved, half curved, round, flattened either from above to 

 below or from side to side, bayonet-pointed, with chisel- 

 shaped ends or merely sharpened. They maj- or may not be 

 fixed in a handle, according to the fancy of the operator and 

 the kind of work required of them. 



For carrying wire, an improved pattern is that designed by 

 Mr. H. C. Reeks, which has a tubular end and two hollow 

 spaces, so arranged that the wire falls into a slot prepared 

 for it, and does not in any way interfere with the passing 

 of the sutures. 



A needle-holder, of which there are several patterns, is 

 a useful accessory ; a pair of Spencer Wells' artery forceps 

 forms a fairly efficient substitute. 



