490 VETERINARY SURGICAL OPERATIONS 



roundings, and the intestines if protruding externally, with 

 abundance of water, warm if obtainable, manually returning 

 the viscera into the abdominal cavity, and then wrapping the 

 body tightly to retain them until adequate preparations can 

 be made for the operation. If possible the patient should be 

 conveyed as quietly as possible to the hospital, where a more 

 thorough operation can be performed. If the prolapsed 

 bowels can be returned and safely retained, the emergency 

 has been met and some time may then be allotted to com- 

 plete the preparations for the following procedure : 



Restraint. — The patient is cast or secured upon the oper- 

 ating table and anesthetized with chloroform. 



First Step. — The region is washed, shaved and disin- 

 fected, with more than ordinary-thoroughness, and to pro- 

 vide against soiling the intestines that may subsequently be 

 forced out through the surgical wound about to be made, 

 sterilized cloths are 'laid below the field. The surface of the 

 body around the wound is moistened with wet sponges to 

 allay loosened hair which may fly into the wound. 



Second Step. — It is now necessary to lay bare the entire 

 tract from the wound in the skin to the opening into the per- 

 itoneal cavity. No matter how long or how short the tract 

 may be, it must .be opened completely. Sometimes its 

 course is just beneath the skin ; at others it enters at once 

 through one or two layers of underlying integuments. In 

 either case the structures constituting the outer boundary 

 of the tract are incised from one end to the other. The 

 bleeding may be considerable, but this is arrested with the 

 forceps or by ligation. If only the skin is incised the bleed- 

 ing will be trivial. The edges of the incision are now parted 

 with tenacula or tumor forceps and the tract submitted to a 

 thorough trimming that will destroy its anfractuosity, and 

 remove the soiled and mutilated shreds and all of the dirt 

 particles or foreign bodies it may contain. Attempt is made 

 to construct a favorable channel for drainage. 



Third Step.— Abdominal lavage is not attempted. If 

 the viscera have been soiled and were not cleansed in the 

 preparatory washing, they are left to the resisting" powers 

 of the body, as any attempt to carry out an effectual wash- 

 ing of the enormous volume of bowels and abdominal cavity 

 is more apt to do harm than good. The wound itself, how- 

 ever, is cleansed with peroxide of hydrogen and then with 

 mercuric chloride, after which it is sprinkled liberally with 

 iodoform. 



Fourth Step. — A perforated rubber drainage tube is now 



