SUTURES. 55 



the opposite side, and fastened in some way suitable to the 

 special pattern of button used. 



Quill Sutures are similar in principle to button sutures, with 

 the exception that an ordinary quill or piece of wood of that 

 shape is fixed on either side of the edges of the wound by the 

 silk or thread. It is suitable for similar wounds to those in 

 which the button suture is applicable. 



Lembert's Sutures are used when suturing the bowel, bladder, 

 or uterus. They are made by passing interrupted sutures 

 through the serous and muscular coats, great care being taken 

 to avoid puncturing the internal or mucous coat, and to ulti- 

 mately bring the two serous surfaces well into contact with one 

 another. Small round sewing needles are the best ones to use 

 when inserting these sutures, as if a flat or bayonet-pointed 

 needle be used the sutures are apt to tear out. 



The Simple Continuous Suture requires no explanation ; it 

 is particularly used for suturing the peritoneum where con- 

 sidered necessary after abdominal operations, and for the skin 

 where the sutures are only intended to be temporary, and where 

 the wound is to be re-opened. 



The Furrier's Suture is not a suitable one where quick heal- 

 ing is desired, as the suture material passes between the edges 

 of the wound, thus causing irritation. 



Halstead's Suture is very useful for some wounds, and is 

 made by passing the suture through the wound, then returning 

 it and tying off on the proximal side. Care must be taken that 

 it is not drawn so tight as to wrinkle the skin, or heahng will 

 be retarded. 



The Needles used for suture purposes are of various sizes, 

 shapes, and patterns. They may be straight, 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 may 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 



