General Surgery 5 



materials, if properly sterilized, is used to better advantage, because, 

 though they do not become absorbed in buried positions, they are 

 safely encapsulated by natural processes and rendered perfectly 

 harmless. It is only rarely that a buried non-absorbable suture 

 needs to be removed. Linen thread, as supplied for sewing ma- 

 chines (it is specially spun so as to travel evenly through the eye 

 of the sewing machine needle) is strong, ties a good knot, is steri- 

 lized by boiling, is not irritative, and can be obtained anywhere 

 where sewing machines are sold, and is therefore a desirable 

 material for fine sutures or ligatures. Rubber bands form an excel- 

 lent material for use as ligatures where portions of vascular internal 

 organs are extirpated. They never slip from position, do not cut 

 through delicate tissues and offer no impediment to the healing pro- 

 cess. Gludc advocates their use in operations where portions of the 

 liver, lungs, or spleen are removed, and Senn has used them to ad- 

 vantage in surgery of the pancreas. 



ABSORBENTS. 



The best sort of absorbent to swab up blood and other fluids 

 during an operation is a pledget of sterilized gauze. 



SUTUEES. 



Of the various sutures used in general veterinary practice, I 

 can commend but two for application to cuticular wounds. These 

 are the "simple interrupted" and Halsted's "buried" or "subcuticu- 

 lar" suture. 



The Subcuticular Suture is undoubtedly superior to any yet de- 

 vised for canine work. Halsted contrived it whilst making a series 

 of experimental extirpations of the thyroid gland owing to the diffi- 

 culty which he experienced in maintaining aseptic wounds with the 

 ordinary suturing which penetrates superficially. It is well-known 

 that the skin, particularly in its upper layers and in the hair follicles, 

 swarms with microbes, and while these in large proportion are 

 * non-pathogenic and do not inhibit the healing process, any suture 

 which passes from without to the subcutaneous tissue of necessity 

 creates a highway for microbic migration. The result is subcuta- 

 neous infection and a wound which, perforce, must heal by sec- 

 ondary intention with suppuration, which is always a slow process 



