Provisional report on healing of arteries after ligature / by J. Collins Warren.

  • Warren, John Collins, 1842-1927.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Provisional report on healing of arteries after ligature / by J. Collins Warren. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    muscular cells. Cross sections were confirmatory of this view. Below this layer was the body of the cica- trix, which consisted of interlacing fibres of connective tissue dotted over with masses of blood pigment. Through this tissue a large vessel made its way from the fundus of the cul-de-sac, rapidly diminishing in size aud breaking up into branches, which anas- tomosed freely with a series of capillary vessels which lay between the slightly retracted walls of the vessel, and communicated with others in the slender liga- ment. We see here an explanation of the immunity of cica- trices of this kind from aneurismal dilatation which occurs so frequently after wounds of vessels. The protective influence of the thrombus insures the devel- opment of a tissue closely resembling the three layers of the vessel wall, and having all the powers of resist- ance which they possess. In the larger vessels of the human subject, where there is less muscular and more elastic tissue, the new muscular tissue is not so evident, but the connective tissue is greatly increased in quantity, and extends for a long distance into the lumen of the vessel. This was seen in a ligatured carotid artery of a man who died four years after the operation. To summarize briefly, the ligatured artery is invested by a protective layer of new tissue formed from the periadventitial tissue, which, if well developed, gives great security against haemorrhage until the permanent cicatrix has grown sufficiently strong. This may be likened to the provisional callus of bone. There is also an internal growth or callus formed from several sources, namely, the intima to a slight extent, the me- dia more largely, also from cells finding their way from the periadveutitia at a late stage through the retracted ends of the vessel. The thrombus is a mere passive structure, takes no part in the growth, but is protective, and affords an excellent medium for the new tissue to germinate in. When the provisional part of the inter-