Practical surgery for the general practitioner / by Nicholas Senn.
- Nicholas Senn
- Date:
- 1901
Licence: Public Domain Mark
Credit: Practical surgery for the general practitioner / by Nicholas Senn. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
91/1184 page 87
![TEMPORARY LIGATION OF ARTERIES. 8/ ''Experiment 2j.—Left femoral artery of goat. Double liga- ture of coarse catgut. Removal of ligatures twenty-four hours after operation. Animal killed nine days after ligation. On re- moval of the ligatures circulation not interrupted. Ligated por- tions of vessel considerably smaller. Lumen not obliterated. Inner walls of vessel at the seat of operation studded with minute patches of exudation material, the product of recent end- arteritis. In operations on the pharynx, parotid, and submaxillary regions for the removal of large tumors in cases in which profuse hemor- rhage is expected, it has been my practice for many years to expose the carotid artery on a level with the upper border of the thyroid cartilage, and to surround the common carotid with a catgut ligature, which is to be used as a temporary or permanent ligature, as the results of the operation might indicate. Such provision against hemorrhage is a great comfort to the surgeon, and in the event of sudden profuse hemorrhage, constitutes a prompt and effi- cient aid in controlling or arresting it. The use of the temporary ligature as a proph\dactic hemostatic has recently received much favor in the practice of Schonborn, Senger, and Riese. There can be little doubt but that it will be made use of in abdominal and pelvic operations, and in disarticulation at the hip-joint as a substi- tute, in appropriate cases, for the permanent ligation of the com- mon iliac artery and its branches. Percutaneous Temporary Ligation of Arteries and Veins.— The prevention of hemorrhage by percutaneous ligation of arteries and veins is not a common practice, but is applicable in exceptional cases. Percutaneous ligation of the common femoral artery has been proposed as a proper precaution for preventing hemorrhage during disarticulation at the hip-joint. It would be difficult to prove the superiority of such a procedure over digital compression of the femoral artery. This prophylactic hemostatic measure may prove to be of value in the removal of vascular tumors by cutting off the blood supply to the part to be removed duiing the opera- tion. Nicaise made use of percutaneous ligation of veins for pre- venting profuse hemorrhage during the removal of very vascular malignant tumors of the mammary gland, and found that it proved u.seful in lessening the amount of hemorrhage. Percutaneous liga- tion of arteries and veins will always prove useful in the removal of vascular growths when elastic constriction can not be applied. The percutaneous ligature should be permitted to remain /// situ until the ligated vessel has become permanently obliterated—that is, from two to seven days, according to the anatomic character and .si/.e of the ligated ve.s.sel. In most of these ca.ses it is advi.sable to interpo.se a small compress of aseptic gauze between the ligature and the surface of the body, which will not interfere with the con- striction of the ve.s.sel and at the same time protect the skin again.st the harmful effects of linear ])rcssure.](https://iiif.wellcomecollection.org/image/b21207513_0091.jp2/full/800%2C/0/default.jpg)
