Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
#Repair of Veins.#--The process of repair in veins is the same as that
in arteries, but the thrombosed area may become canalised and the
circulation through the vessel be re-established.
HÆMORRHAGE IN SURGICAL OPERATIONS
The management of the hæmorrhage which accompanies an operation includes
(a) preventive measures, and (b) the arrest of the bleeding.
#Prevention of Hæmorrhage.#--Whenever possible, hæmorrhage should be
controlled by _digital compression_ of the main artery supplying the
limb rather than by a tourniquet. If efficiently applied compression
reduces the immediate loss of blood to a minimum, and the bleeding from
small vessels that follows the removal of the tourniquet is avoided.
Further, the pressure of a tourniquet has been shown to be a material
factor in producing shock.
In selecting a point at which to apply digital compression, it is
essential that the vessel should be lying over a bone which will furnish
the necessary resistance. The common carotid, for example, is pressed
backward and medially against the transverse process (carotid tubercle)
of the sixth cervical vertebra; the temporal against the temporal
process (zygoma) in front of the ear; and the facial against the
mandible at the anterior edge of the masseter.
In the upper extremity, the subclavian is pressed against the first rib
by making pressure downwards and backwards in the hollow above the
clavicle; the axillary and brachial by pressing against the shaft of the
humerus.
In the lower extremity, the femoral is controlled by pressing in a
direction backward and slightly upward against the brim of the pelvis,
midway between the symphysis pubis and the anterior superior iliac
spine.
The abdominal aorta may be compressed against the bodies of the lumbar
vertebræ opposite the umbilicus, if the spine is arched well forwards
over a pillow or sand-bag, or by the method suggested by Macewen, in
which the patient's spine is arched forwards by allowing the lower
extremities and pelvis to hang over the end of the table, while the
assistant, standing on a stool, applies his closed fist over the
abdominal aorta and compresses it against the vertebral column.
Momburg recommends an elastic cord wound round the body between the
iliac crest and the lower border of the ribs, but this procedure has
caused serious damage to the intestine.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account