The American Association of Genito-Urinary Surgeons

1903 Boston Medical and Surgical Journal  
While this part of the operation was being done, the abdomen was thoroughly flushed out with gallons of salt solution until the turbid serum was entirely washed away. Two counter incisions in the flanks were made and cigarette wicks of gauze and rubber dam were introduced in all directions, two in each flank dan three in the central incision. A rubber drainage tube was also introduced, covered with gauze, to the bottom of the pelvis. A Mixtcr tube was then tied into the cecum, which was drawn
more » ... , which was drawn to the umbilicus for this purpose and the wounds were partially united with silkworm gut. The patient stood the operation well, and was at no time in an alarming condition of collapse. The operation consumed less than forty minutes. After the operation the drainage tube was emptied by a catheter and suction syringe, at intervals of every half hour in the day and every two hours at night. One to two drachms of fluid were usually obtained during the first week. On the day after operation an enema through the colostomy tube was followed by a good result. The patient was fed on nutrient enemata until the 9th day, when small doses of milk and lime water were allowed. On the sixth day all of the wicks and the rubber drainage tube had been removed, and the Mixter tube had come away, leaving a fecal fistula. On the thirteenth day the wound was drawn together with straps, and in two weeks the fistula had closed. At the present time, just over three months after the operation, the wound is solid and the patient is eating well and feels in perfect health.
doi:10.1056/nejm190310291491806 fatcat:ljcciamxm5ejvop4uwfzcari54