RUMBNOTOMY 83 



securely in a manner to retain the lips of the rumenal 

 wound in the position designated in the figure. 



The operator may now introduce his hand and arm freely 

 into the rumen, can remove part or all of the ingesta as may 

 be desired, and search the interior of the rumen and reti- 

 culum for foreign bodies or other evidences of disease. 



Having completed the examination and applied any 

 therapeutic agent advisable, carefully wash away any 

 ingesta which has escaped from the rumen. The wound in 

 the rumen is then to be sutured, using the I,embert type 

 as shown in Figs. 31, 32. Heavy silk or linen should be 

 used and care taken not to pass the suture into the rumenal 

 cavity but only through the serosa and musculosa. If they 

 penetrate the rumenal cavity, the digestive juices act 

 quickly, destroy them and permit the wound to reopen. 

 The closing of the wound in the rumen should not be in- 

 trusted to a single row of sutures, but instead should have 

 three separate sets of the same material applied in the same 

 manner, the second set burying the first, and the third 

 burying the second, as indicated in Fig. 32. The third 

 row of sutures may be of catgut having an absorbable 

 period of 20 days if preferred. The lips of the rumenal 

 wound may be conveniently held with the aid of heavy 

 fixation sutures below and above the lower and upper 

 wound commissures respectively, sinylar to the plan for 

 fixing the intestine as shown in Fig. 34a, page 86, and by 

 having an assistant hold these firmly. 



The suture area may now be carefully wiped clean and 

 permitted to drop away into the abdomen. * 



The margins of the peritoneal wound are next to be 

 grasped with forceps and sutured with heavy, slow-absorb- 

 ing catgut. The muscle layer is best closed by means of 

 very deep and quite heavy interrupted sutures, carried 

 through the skin. These should be carefully laid and left 

 untied until the skin wound is carefully closed by shallow, 



