. A new manual of surgery, civil and military. red, on account of their elasticity,the transverse perineal muscles were completely torn and the levator animuscles separated. Operative technique. A transverse incision is made through the septumremaining between the rectum and vagina, and the tissues of the vaginal wallcarefully dissected loose from those of the rectal wall, forming a large flap,which is carried forward into the vagina—the entire septum being split fromside to side. After the incision through the skin and through a short distanceof cicatricial tissue which usually exists underne
. A new manual of surgery, civil and military. red, on account of their elasticity,the transverse perineal muscles were completely torn and the levator animuscles separated. Operative technique. A transverse incision is made through the septumremaining between the rectum and vagina, and the tissues of the vaginal wallcarefully dissected loose from those of the rectal wall, forming a large flap,which is carried forward into the vagina—the entire septum being split fromside to side. After the incision through the skin and through a short distanceof cicatricial tissue which usually exists underneath the skin, the separationof these flaps may be accomplished most readily by grasping the vaginal flapwith dissecting forceps and shoving away this section—the posterior flap— SURGERY OF THE FEMALE PELVIS 649 by means of the finger, covered with several layers of moist aseptic gauze. Inthis manner a flap, as shown in the plate, can be produced in a few exposes the tissues on each side which originally formed the perineum,. Pekineorrhapht. The recto-vaginal septum has been split and the vaginal flap (e) drawn forward. Asilkworm gut suture (aa) has been applied to the anterior flap, which, when tied, will makea new floor for the vagina. A similar suture (b) is applied to the posterior flap. Thesesutures extend to, but not through, the mucous membrane in either case. The sutures caughtin the forceps, marked (c), pass through the lateral flaps, but they are left untied until eachsuccessive tissue on either side has been united with the same tissue on the opposite side bymeans of the continuous cat-gut suture marked (d). After the deep tissues have been unitedwith the silkworm gut sutures (c) are tied. and by carefully uniting these, after the manner to be described, a perineummay be constructed which will be as thorough a support as the originalstructure. The anterior flap is drawn forward and a row of interrupted ten-sion sutures applied, as indicated in the p
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
