I054 Veterinary Obstetrics 



pie. Various types of clamps are listed by veterinary instru- 

 ment makers, based upon the recommendation of practitioners 

 who have used them and found them satisfactory ; but no one 

 possesses any special advantage, and the practitioner may readily 

 make clamps from a stick of wood which will answer all essential 

 purposes. The clamps are applied essentially the same as the 

 ligature. The animal is secured upon its back ; the contents of 

 the hernial sac returned into the abdomen ; the sac firmly 

 grasped ; and the clamps applied antero-posteriorly, as close to the 

 abdomen as possible, and fixed very tightly so as to cut off the 

 circulation from the sac and cause its death. 



Two dangers confront the practitioner in the use of clamps. 

 Some have found that, as with the ligature, the clamps may 

 cause a very rapid gangrene, with consequent early sloughing 

 and protrusion of the intestines. In our own experience we have 

 found the clamps inefficient. After having applied them as close 

 to the abdominal floor as possible, and secured them very tightly, 

 we succeeded in producing necrosis and the destruction of the 

 entire hernial sac. However, while this was going on the intes- 

 tines were constantly pressing through the hernial ring, so that, 

 when the sac, which had been included between the clamps, had 

 completely sloughed off, it was found, to our disappointment, that 

 the weight of the intestines from above had pushed the skin down- 

 ward and a new hernial sac had formed, which, though somewhat 

 less in size, was just as objectionable as the original defect and 

 required further surgical attention. 



If clamps are to be applied, the operation should be carried out 

 under antiseptic precautions, the area shaved and disinfected, and 

 either general or local anaesthesia induced. The hernial sac is to 

 be grasped, drawn out as far as possible, and the clamps applied 

 close to the ring, including all the tissues which can be drawn 

 into them. The clamps are then to be closed by means of forceps, 

 and secured with a cord. An abundance of antiseptic cotton 

 or gauze is then to be packed about the clamps and over the in- 

 carcerated sac, and over this a strong bandage is to be placed, and 

 well secured in position in such a manner that it will hold the 

 clamps tightly against the umbilic ring. By so doing, the hernial 

 sac is held against the ring, and the inflammation caused by the 

 necrosis of the sac induces inflammatory adhesion and closure of 

 the hernial ring. 



