StThomas's Hospital reports . opposite its original point of entrance at the rectalmargin. The needle is now removed and the suture tiedThis will bring into perfect apposition the edges of therectal rent near its apex. The ends of the suture will be inthe rectum (see diagram, Fig, C). Other sutures—two orthree in number, according to requirements—are thenpassed one by one from above downwards until the rectal Vhas been completely closed. Each suture must be tiedbefore tlie next is introduced, and care must be taken thatthe ends of the suture or sutures already introduced arepushed back out of
StThomas's Hospital reports . opposite its original point of entrance at the rectalmargin. The needle is now removed and the suture tiedThis will bring into perfect apposition the edges of therectal rent near its apex. The ends of the suture will be inthe rectum (see diagram, Fig, C). Other sutures—two orthree in number, according to requirements—are thenpassed one by one from above downwards until the rectal Vhas been completely closed. Each suture must be tiedbefore tlie next is introduced, and care must be taken thatthe ends of the suture or sutures already introduced arepushed back out of the way, so that they may all hang inde- The sutures should include no mucous membrane. Hence if the mucousmembrane has become everted, it may be necessary to trim away the evertededge before passing the sutures. of the Female Perineum. 441 pendently into tlie rectum, aud not become entangled withthe succeeding stitches. When all the rectal stitches havebeen introduced, the ends uaxx be cut off at the anus. It is Fig. Diagram to show rectal stitcli as seen in cross a, denuded surfaces, h h, rectal canal, c. rectalsuture. better not to cut the ends short at the moment of tying thesutures, as if this is done it is difficult to keep the ends frominsinuating themselves between the raw surfaces. The endsshould project into the rectum, and this is best ensured bykeeping them long until they have all been tied. The dia-gram (Plate II, fig. 4) shows the rectal sutures all in positionready to be tied. In practice, as I have said, each sutureis tied before the next one is introduced. It will now be convenient to close the opening in thevaginal flap—the vaginal Y. This is easily effected byordinary interrupted sutures of silkworm gut introduced onthe vaginal aspect of the flap, so that the ends may projectinto the vagina. With this object the flap, hitherto heldforwards by an assistant, is now drawn down. The firstsuture is inserted close to the apex of the V (which no
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