Diseases of women : a manual for students and practitioners / by Charles Gardner Child, jr. Illustrated with 101 engravings.

  • Child, Charles Gardner, 1873-1941.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of women : a manual for students and practitioners / by Charles Gardner Child, jr. Illustrated with 101 engravings. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    180/222 (page 182)
    heavy chromic catgut, kangaroo tendon, silk or linen thread cut in one foot strands is generally used, and may be passed on either a large full curved needle or a ligature carrier. The knots should be tied as tight as possible without breaking, and the tissue cut far enough away to avoid all danger of subse- quent slipping. In most cases the quilting of the broad liga- ments should be done part way on one side, and then on the other, so that the uterus and appendages may be further delivered into the vagina with each succeeding step. If the uterus is large it may be safely hemisected, after both uterine arteries have been tied, and each half removed separately, or by morcellation. When contraction of the broad ligaments makes ligation beyond the uterine arteries difficult or impos- sible, the angiotribe may be used instead. It should remain on the tissues two minutes before they are divided. At the end of the hysterectomy the broad and round ligament stumps should be drawn down and sutured to the raw edges of the vaginal vault and the longitudinal incision in the anterior vaginal wall closed. Enough gauze (10 per cent, iodoform) should be introduced into the peritoneal cavity to keep the intestines and omentum away from the wound, and the vagina tightly packed. The vaginal gauze is removed on the third day and a vaginal douche of boric acid solution (3 j to Oj) given twice a day thereafter. The withdrawal of the peritoneal gauze is begun on the fourth day, a few inches being removed at each dressing until it is all away, usually by the eighth day. Any granulation tissue in the vaginal wound should be cauter- ized every other day with silver nitrate. Abdominal Celiotomy.—The preparation of the patient is begun twenty-four hours before operation. The bowels are thoroughly opened and all hair removed from the vulva. The abdomen from the umbilicus to the pubes is scrubbed for five minutes with tincture of green soap, rinsed off with sterile water, and rescrubbed for two minutes with Stewart's solution, followed by a cleansing with water. A protective dressing of sterile gauze is applied. The same preparation of the field