SUTURING 



107 



been described in veterinary literature. The reaction which 

 so frequently precedes the absorption of buried sutures in 

 veterinary operations is obviated by the removal of the deep 

 suture without opening the wound to search them out. In 

 the various laparotomies, where skin, aponeurosis, muscle 

 and peritoneum must need coaptation; and in incisions on the 

 extremities where skin, fascia and muscle are divided, these 

 sutures are indeed valuable expedients. They are individual 

 sutures inserted as follows : The needle passes from without 

 inward through the outer integument, from without inward 

 through the inner integument of the opposite side, from 

 within outward through the inner integument of the first side 

 and finally from within outward through the outer integu- 

 ment of the opposite side. The protruding ends are then 



£§§ =— *" '*-. 



Fig. 60— Three Czerney Sutures and Four Lambert in Enterorrhaphy. 

 A— Lembert's Suture. B— Czerney's Suture. 



carefully drawn taut and tied externally. When tied they 

 resemble the simple interrupted suture. (Fig. 59.) 



Czerny-Lembert Suture. — This double suture is the most 

 appropriate to adopt in veterinary surgery for suturing the 

 hollow abdominal and pelvic organs,— intestines, stomach, 

 rumen, uterus, bladder, etc., when these are accidentally or 

 surgically divided. The combination of these two sutures 

 constitutes the most reliable method of closing intestinal 

 wounds, whether for circular, transverse or longitudinal en- 

 terorraphy. The two sutures are placed consecutively in the 

 order indicated in the name. The Czerny suture, which is 

 a series of interrupted stitches, is placed as follows: The 

 needle is passed through the serous and into the muscular 

 coat and then out of the cut end of the organ (bowel, stom- 

 ach, etc.) between the serous and muscular coats; (Fig. 60) 

 then it is brought over the wound to the other edge and 



