The practice of obstetrics, designed for the use of students and practitioners of medicine . the pointagain in the deepest part ofthe wound. Operation.—In the slight-er degrees of laceration an-esthesia is not usually neces-sary, the tissues being benumbed by pressure, and the patient still perhaps par-tially under the influence of an anesthetic. In the severer forms in which carefulsuturing is required, anesthesia will usually be needed, and if such a rupture occursit is best, if an anesthetic has been administered during the expulsion of the head,to continue its use until the laceration has
The practice of obstetrics, designed for the use of students and practitioners of medicine . the pointagain in the deepest part ofthe wound. Operation.—In the slight-er degrees of laceration an-esthesia is not usually neces-sary, the tissues being benumbed by pressure, and the patient still perhaps par-tially under the influence of an anesthetic. In the severer forms in which carefulsuturing is required, anesthesia will usually be needed, and if such a rupture occursit is best, if an anesthetic has been administered during the expulsion of the head,to continue its use until the laceration has been repaired, thus obviating thenecessity of re-anesthetizing the patient, and lessening the amount of the anes-thetic to be administered. (Compare Management of Labor, Part IV.) Thepatient is placed in the lithotomy position with the hips drawn well over theedge of the bed or table, and the upper part of the vagina is temporarily packedwith sterilized gauze to check the flow of blood and enable the operator tosee what he is doing. The instruments needed are: needle-holder; small and. Fig. 1270.—First Degree or Superficial Perineo-vaginal Laceration of the Pelvic Floor. BothVaginal Sulci Involved. Shows Method of Pass-ing THE Stitches for Repair. Note the numericalorder of passing the sutures. OPERATIONS FOR THE CORRECTION OF INJURIES 1035 medium-sized curved needles; a pair of scissors; a speculum or retractor for theanterior vaginal wall (in tears of the third degree it is well to have two retractors,one for each side); tenacula; suture material. A needle-holder is not absolutely necessary unless the laceration extends farup into the vagina. Retractors may be improvised from bent spoons. A singlesuture with the ends left long and held by an assistant takes the place of a tena-culum, and ordinary sewing-needles or darning-needles sterilized in a flame maybe used in an emergency. Silk, silkworm-gut, catgut, or silver wire may be is preferable for the vagina, si
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
