100 VETERINARY SURGICAL OPERATIONS 



serous membranes, laminse of fascia, aponeuroses, muscles 

 and skin may all be submitted to this surgical process, but it 

 is the latter that is most frequently approximated by sutures, 

 because it is this integument that determines the physiog- 

 nomy of the wounded region after the reparative process is 

 complete. To heal the skin by primary union prevents the 

 indelible hairless blemish that otherwise always succeeds 

 wounds on the surface of the body. 



Sometimes sutures are indispensable, A severed nerve 

 trunk will much sooner restore the lost innervation if the two 

 cut ends are brought into perfect apposition with sutures ; 

 and the tendons will repair much more rapidly and are never 

 in danger of permanently losing their continuity if thus ap- 

 proximated. In surgery of the intestines and of blood ves- 

 sels sutures cannot be omitted ; the life of the patient depends 

 upon them. Whenever an intestine or any other tubular 

 organ (ducts, etc.) is accidentally or surgically incised, the 

 lost continuity must be at once restored artificially. Here, 

 the breach cannot be left to nature's regenerative forces, as 

 in the case of fixed structures, such as skin muscles, etc. 



CONTRA-INDICATIONS.— Sutures are very often 

 contra-indicated in wounds on the surface of the body. When 

 a wound has been or is certain to become infected with viru- 

 lent microorganisms, sealing it over by suturing the skin or 

 other integuments is only "shutting up the wolf in the sheep 

 pen." They may thus be applied to the advantage instead 

 of the hindrance of microbian growth. -By preventing secre- 

 tions, harmless in themselves, from flowing out, food is pro- 

 vided for bacteria which might have died from want of suffi- 

 cient nourishment or by having fallen prey to the leucocytes. 

 In short, infected wounds or wounds which on account of 

 their nature will discharge more or less profusely, must never 

 be sutured ; it is always preferable to leave them wide open. 

 Sometimes, in order to diminish the size of the scar the up- 

 permost part may be closed and the dependent part left open 

 as a drainage orifice. 



It is also not advisable to attempt suturing where swell- 

 ing or the anatomical constitution of the part, will bring 

 great tension upon the sutures. The taut suture, by pressing 

 upon the tissues, cuts them and soon defeats the purpose for 

 which it was applied ; by strangulating the circulation it pre- 

 vents instead of promotes healing; and by causing pain it 

 adds discomfort to the patient. 



Conclusions. — (i) Sutures are indicated in all aseptic 

 incised wounds where the secretions will be limited, imper- 



