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The "ideal" intestinal suture is one which will combine simplicity, strength, rapidity of insertion, and absolute insurance from leakage. Without going exhaustively into the relative merits or demerits of the various sutures now in vogue, I would like, however, to mention a few points regarding the one probably most widely in use at present, i. e., the Halsted suture. In Diagram 1 are shown Halsted sutures inserted, but not tied. When the knot is tied the serous surfaces of the bowel are approximated, and cut edges inverted, but, not only do the sutures draw longitudinally on being tied, and thus draw the wound together, but at the same time they draw laterally, as indicated by the arrow-heads. This latitudinal tension tends to draw the sides of the sutures together, but at the same time draws the sutures away, each from the other, leaving weak points as indicated in Diagram 2.
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