Surgical Treatment; a Practical Treatise On the Therapy of Surgical Diseases for the Use of Practitioners And Students of Surgery V.2

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Flat sponges (see Vol. I, page 42) are used for keeping coils of intestine out of the way and covered. Such sponges should be used wet and warm. To prevent the irritation which produces adhesions, rubber tissue should be interposed between the gauze and peritoneum (see Fig. 1 188. — Rubber Retractor.
Device of Dickinson shown in position in median abdominal wound.
page 521). Flat sponges may be used for blood. Sponges on clamps are employed where frequent sponging in deep cavities is required.
...Protection of peritoneum from every unnecessary insult is imperative.
This is accomplished by doing no more than is necessary, by gentle handling of all peritoneum-covered surfaces and by keeping the peritoneum warm.
Coils of intestine coming in the field of operation should be pressed back and held covered with warm pads. The flat laparotomy pads or small towels, wrung out in hot water, are best. The experienced surgeon is able soon to wall off the rest of the abdomen and leave exposed only the site of operative attack.


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