LAPAROTOMY. 89 



some of its internal organs, or as a treatment for tubercular 

 peritonitis.^ On the day preceding any major abdominal 

 operation the patient should be bathed and washed in some 

 disinfectant solution, no solid food being given for about 

 twelve hours before. After carefully shaving, removing grease 

 from the skin with ether, and rigidly disinfecting the parts, 

 administer an anaesthetic and fix the animal on its back with 

 the limbs well extended. Incise the skin in the median line, 

 the actual situation chosen depending upon which organ is to 

 be operated upon. Carefully arrest all haemorrhage either 

 with artery forceps or tampons of aseptic wadding, puncture 

 the peritoneum, insert a director, and, with the aid of a 

 scalpel, make an incision of the required length. 



After doing whatever is necessary to the internal organs, 

 carefully remove all blood from the neighbourhood of the 

 wound, suture the peritoneum with fine silk, the muscles with 

 silkworm gut, and the skin with silk or catgut. The peri- 

 toneum and muscles may be taken together, and some practi- 

 tioners suture all three layers (peritoneum, muscles, and skin) 

 at once, but this method cannot be as safe as if they are 

 taken separately. A continuous suture may be used for the 

 peritoneum, but interrupted sutures are unquestionably the 

 best for the muscles and skin, as, if septic infection takes 

 place, it is much more convenient for the cleansing and 

 dressing of the wound. 



In order to complete the operation the exterior is carefully 

 dried with aseptic wadding and covered with iodoform (or 

 orthoform) and collodion. 



Occasionally in large dogs, where a long incision has been 

 made, a bandage is useful over this to give support to the 

 edges of the wound, but in the majority of cases this is not 

 necessary and only forms a source of annoyance and irritation 

 to the patient. Care must be taken to keep the animal 

 perfectly quiet for about ten days, and on no account to allow 



1 Watson Cheyne, "Britisli Medical Journal," 23rd December 1899. 



