Is a fat stitch necessary?

Two hundred and eight consecutive patients undergoing surgery were allocated randomly in a trial of the use of a plain catgut subcutaneous fat stitch, compared with no fat suture. There was no appreciable difference between the two trial groups in wound infection rate following either clean (4 out of 74 with and 1 out of 68 without a fat stitch) or contaminated operations (4 out of 27 with and 4 out of 41 without). Likewise, there were no differences in haematoma rates. There is therefore no appreciable benefit to be derived from the use of this stitch.

Mesenteric panniculitis

A case of mesenteric panniculitis is presented, with a review of previous reports.

The anal cushions--a fresh concept in diagnosis

The anal canal is lined by cushions of specialized submucosal tissue which assist the continence mechanism. Starting with that premise, its various afflictions are examined and found to be more logically related, and much more readily understood.

The surgical anatomy of the superficial and perforating veins of the lower limb

The superficial venous system was dissected in 60 legs. A possible function is ascribed to the long saphenous vein and an argument against its stripping in varicose veins presented. Abnormality of the long saphenous vein and its association with varicose veins is described. Particular features of the saphenous tributaries are noted and their relevance in varicosity discussed. The perforator system is described, the distinguishing properties of the medial ankle perforators being examined and their anatomical confinement delineated.

Abdominal-wall tenderness: A useful sign in the acute abdomen

120 patients admitted as an emergency with localised abdominal pain were tested for abdominal-wall tenderness. Of the 24 patients with a positive test only 1 had a detectable intra-abdominal cause. In the remaining 23 no reason for the pain could be found.

Cholecystectomy cholangiogram snare

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