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The After-treatment of Difficult Laparotomies.
—P. Müller, of Berne, reports a case in which adhesions took place between the anterior and posterior walls of the abdomen over an extent of 25 cm., in such a manner as to include a knuckle of small intestine. In order to prevent such accidents he advises the avoidance of bandages which exert pressure in all cases where there are extensive wound surfaces in the peritoneum. In the second place he proposes to prevent adhesions by filling the abdominal cavity after laparotomy with a sterilized neutral solution. He employed this method in a case in which he found extensive adhesions, using 2,400 grams of a 0.7 per cent, solution of salt, which he poured into the abdominal cavity through a drainage-tube introduced into the upper angle of the incision. This sufficed to fill up the cavity, occupying as much space as the tumor had previously
MEDICAL PROGRESS.. JAMA. 1887;IX(16):495–496. doi:10.1001/jama.1887.02400150015002