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DEPARTMENT OF SURGERY. 
of a series of Czerny’s stitches which may be of silk or linen ; 
and the series of stitches that surround it is a Lembert suture, 
and should be made of catgut, which is absorbed after cicatriza¬ 
tion. This is one of the most reliable methods and should be 
adopted, if possible, whenever intestinal sutures are indicated ; 
it can be used in approximations (Fig. 6), end-to-end anastomo¬ 
sis and enterorrapliy (Fig. 5). 
The technique is as follows : The stitches of the inner 
row are made as in the Czerny method (Fig. 4 a, and 5^) ; they 
are ligated carefully and when completed, a row of Lembert’s 
stitches surrounding it, is applied and ligated ; which, when 
properly and carefully done, makes a neat and substantial su¬ 
ture. The inner row of stitches bind the mucous and muscu¬ 
lar coats of each end or edge together firmly, and relieves the 
outer row of stitches of part of their strain, and makes a very 
favorable condition for immediate union. 
Ligation of Sutures .—In tying the stitches used in abdomi¬ 
nal and intestinal sutures, the following knots are usually 
selected, viz. : • 
(a) Granny knot. 
( 5 ) Sailor’s knot. 
(c) Friction knot. 
(d) Surgeon’s knot. 
(e) Combined surgeon and sailor’s knot. 
FIG. 9. 
a —Granny knot ; b —Sailor’s knot ; c —Friction knot ; d —Surgeon’s knot ; 
e —Combination, consisting of a surgeon’s knot with part of a sailor’s knot. 
