DEPARTMENT OF SURGERY. 
213 
Before attempting such operations the bowels should be 
emptied as much as possible and the peristalsis suspended with 
opium. If there is any septic matter in the cavity it must be 
well irrigated ; the sutures must be pure beyond doubt, and 
should never pass through the three coats of the intestine on 
account of the danger of infection from the contents of the 
bowels; for stitch suppuration will surely prevent a favorable 
termination. 
The sutures used in intestinal approximation and anastomo¬ 
sis or in such operations as enteroraphy and enterostomy should 
be made with a curved needle, and the ligatures used in each of 
the above mentioned procedures should be selected as follows : 
(i) Catgut for stitching the serous coats and (2) silk when close 
apposition is desired and firm sutures required. 
(1) In stitching the serous coats, catgut should be used be¬ 
cause it is readily absorbed and leaves no ligature sinuses which 
are often the cause of much trouble after such operations. It 
should be carefully sterilized, being more difficult to disinfect 
than silk, therefore special care should be given to this proced 
ure ; for it is generally conceded that a large percentage of fail¬ 
ures in these operations is due to stitch suppuration, which can 
in no way be avoided but by the adoption of correct aseptic 
methods and the proper selection of sutures. 
(2) Silk sutures may be used, and in fact are preferred in 
stitching the edges of the surgical wound, which slough and 
JOBERT’S SUTURES. 
Fig. 1. Stitch used for suturing intestinal incisions. 
Fig. 2. Jobert’s invagination suture. 
Fig. 3. Jobert’s method of approximation. 
pass off with the contents of the intestines. In such instances, 
the stitches are required to be more firm and reliable than cat- 
