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• W57041805 abstract "T HE purpose of this articIe is to stress the importance of observing certain we11 defined principIes of surgica1 technic, and to make a comparison of the resuIts obtained when using (I) jbe sills, (2) fine chromic catgut, and (3) large catgut (chromic and plain). This series consists of 400 unseIected and consecutive cases in which the peritoneal cavity was opened. There are 125 consecutive patients in each of the fine silk and large catgut (chromic and pIain) groups, and 150 consecutive patients in the fine chromic catgut group. The instructions given to the interns on the use of and the cIinica1 investigation of fme chromic catgut* were as foIIows: I. This investigation is being conducted to determine: (a) If as satisfactory resuIts couId be obtained when using fine chromic catgut as were obtained when using fine silkt; and (6) to make a comparison between the resuIts obtained when using fine chromic catgut with a refined technic, and Iarge catgut (chromic and pIain) as ordinariIy used.. 2. The skin, subcutaneous tissues, muscIes and fascia must be compIeteIy covered with Iaparotomy pads or toweIs immediately after making the incision, and they shouId be kept covered unti1 they are ready to be cIosed. After the peritoneum is opened the moist Iaparotomy pads or toweIs shouId be attached to it. * From the surgica1 services of the Norfolk Genera1 HospitaI and NorfoIk NavaI HospitaI. t Principles of surgical technique with particuIar reference to the use of silk. Am. J. Surg., 45: 309-315, 1939. 3. SmaII hemostats, smaI1 forceps, smaI1 needIes and smaI1 needIe hoIders shouId be used. 4. The incIusion of Iarge amounts of tissue when Iigating and transfixing bIeeders shouId be avoided. 5. CarefuI hemostasis is one of the most important factors in avoiding postoperative compIications. 6. It is suggested that the foIIowing sizes of hne chromic catgut be used: (a) No, oooo shouId be used for Iigating and transfixing smaI1 vesseIs. (6) No. ooo shouId be used for Iigating a moderateIy sized vesse1. (c) When a moderateIy Iarge or a Iarge vesse1 is to be Iigated, use No. oo or No. o. (d) For cIosing the peritoneum and transversaIis fascia, No. o is advisabIe. (e) For suturing muscIe No. oooo or No. ooo shouId be used. (f) For cIosure of fascia use No. o, except in Iong upper abdomina1 incisions or where there is much tension it may be necessary to use No. I. (g) Under no circumstances shouId a size Iarger than No. I be used for any purpose. (h) OnIy the fine chromic catgut which has been furnished by one manufacturer wiI1 be used in this investigation. 7. A square knot shouId be used for the majority of Iigatures of smaI1 vesseIs, but for Iarger vesseIs a surgeon’s knot or a tripIe throw knot tied square wiI1 be necessary, the Iatter being preferabIe to the surgeon’s knot when using catgut. “Granny knots ” must be avoided. The sutures shouId be cut cIoser to the knot than they would if Iarge catgut were used, but the Iength of the suture from the knot shouId" @default.
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• W57041805 date "1942-07-01" @default.
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• W57041805 title "The principles of surgical technic" @default.
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• W57041805 doi "https://doi.org/10.1016/s0002-9610(42)90959-0" @default.
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