THE UNITED STATES PHARMACOPEIA FOR 1910
Journal of the American Medical Association
BALTIMORE Surgeons everywhere are familiar with the ordinary figure-of-eight suture, and those who have employed it must have recognized its value as an economizer both of time and of suture material. It possesses still other merits, chief among which are first its simplicity; second, its very wide field of application; and third, the fact that it combines some of the advantages of both the continuous and the interrupted suture. All these Fig. 1 .-Closure of midline incision below the
... The peritoneum has been closed by a ujihuh.ous suture. At the upper angle of the incision a double figure-of-eight suture has been intro¬ duced and tied, doing the work of three interrupted sutures. A second suture has been introduced, but has not been drawn taut. It shows clearly that traction on one end is transmitted directly to the upper loop, approximating the tissues included in the upper half of the suture, whereas the same result is accomplished over the lower half by traction on the opposite end. Thus, when the ends are tied there is a uniform strain on the suture, and no puckering. Two or three of these sutures suffice to close the average incision. factors have participated, of course, in popularizing this suture, especially among abdominal surgeons and gyne¬ cologists. A few months ago it occurred to me to add another loop to this already useful suture, thereby making a double figure-of-eight, and thus, in a limited field of ap¬ plication, at least, greatly increasing its value. After subjecting this innovation to a practical test at the operating table in a large number of cases, I am convinced that it renders the suture a distinct improve¬ ment over the single figure-of-eight, in that it repre¬ sents a gain of exactly 33.33 per cent, in every point of advantage that the latter possesses. I have used this form of suture chiefly in the closure of abdominal and lumbar incisions, where the closure was done in layers, and also after myomectomy, finding it especially useful in obliterating dead space, effecting neat approximation, and in controlling hemorrhage. Single Fig.8 suture Double Fig. suture Fig. 2.-The ordinary and the double figure-of-eight suture sche¬ matically shown.