Publisher's Synopsis
Excerpt from Electro-Hæmostasis in Operative Surgery
Were this all of the evil that can be charged fairly against the silk ligature one might rest satisfied, but worse follows the use of ligatures of all kinds in abdom inal and pelvic surgery. Ligatures applied to the broad ligament pedicles of ovarian tumors and Fallopian tubes are guilty of much wrong-doing. For example, unless the conditions are unusually favorable, the pedicle of an ovarian tumor can not be tied tightly enough to close the arteries in the way that surgeons say they should be ligated to make sure of controlling haemorrhage with cer tainty. There is a liability, in thick pedicles, for the tissues to shrink under the pressure of the ligature and permit the vessels that have been temporarily closed to open again and allow bleeding to take place. This inefficiency of the silk ligature has been observed by Dr. Howard A. Kelly, so that he has adopted the method of ligating the pedicle in two sections, by including the ovarian arteries in one ligature and the tubal and uterine side of the pedicle in the other, and in addition to that he also ligates the larger vessels in the end of the stump.
Whenever the tissues of the pedicle are rendered friable by disease or degeneration, it is well-nigh impossible to con trol haemorrhage with a ligature Of any kind. Silk is as bad as or worse than anything else, for it cuts the tissues if tied as tight as possible without breaking.
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