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It occasionally becomes necessary during the course of an obstetric or surgical practice to pack the uterine cavity. It also occasionally occurs that more than one length of packing gauze is needed to fill the cavity. Unless difficulty is to be experienced in removing the gauze, it is essential that each successive strip of gauze be united firmly to the one that precedes it. In the past, the general practice has been to tie the ends of the strips together by means of the square knot. It has happened that, following the packing and after the physiologic contraction of the cervix, the large bulk of the knotted gauze so formed offers considerable resistance to easy removal. The difficulty so encountered has been so severe as to make necessary a general anesthetic and a minor operative procedure to secure adequate room for the removal of the gauze knot. It was to overcome this difficulty that the procedure described here was devised.
Spangler PE. A SLIGHT IMPROVEMENT IN THE TECHNIC OF INTRAUTERINE PACKING. JAMA. 1926;87(10):754. doi:10.1001/jama.1926.92680100001009b
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