. The Principles and practice of gynecology : for students and practitioners. )e made of the direction or directions and extentof the rupture, by trial approximations of the torn fragments invarious ways with a tenaculum in each hand. If there be a simplebilateral laceration, the operation will be as follows : Denudation.—With the tenaculum and curved scissors the surfacesto be united are denuded. Figure 303. Inasmuch as one of the im- 35 570 TRAUMATISMS. portant functions of the uterus is drainage, it is essential to leave awide and free outlet at the external os. To this end, that portion of
. The Principles and practice of gynecology : for students and practitioners. )e made of the direction or directions and extentof the rupture, by trial approximations of the torn fragments invarious ways with a tenaculum in each hand. If there be a simplebilateral laceration, the operation will be as follows : Denudation.—With the tenaculum and curved scissors the surfacesto be united are denuded. Figure 303. Inasmuch as one of the im- 35 570 TRAUMATISMS. portant functions of the uterus is drainage, it is essential to leave awide and free outlet at the external os. To this end, that portion ofthe undenuded mucosa which is to line the restored external os shouldbe left wide, so that when united the normal trumpet-shape of thelower segment of the cervical canal will be preserved. Immediatelyafter the operation the diameter of the restored external os should beeven larger than normal, so that the involution that follows theoperation will reduce it ultimately to the normal calibre. Figures304 and 305 show the properly curved lines between the denuded FiGITEE Shows the surface denuded and two sutures in place, but not tied. Left lateroprone position;exposure by Sims speculum. and undenuded surfaces. Extreme stenosis at the external os, some-times amounting to complete atresia, is a possible result of inattentionto this important detail. Among the consequences of stenosis and obstruction in the uterinecanal are the following : 1. Retention and decomposition of uterine secretion and men- strual fluid. 2. Possible destruction of the Fallopian tubes. 3. Metritis, endometritis, and salpingitis. PUERPERAL LACERATION OF THE CERVLX LTEIU. 071 Tlie conditions niontionod above may ^ivo rise to immediate disas-trous results, (»r may eause persistent invalidism. 1lie rapid and com-plete relief which often follows the reopeninir of a contracted cervicalcanal ami os externum proves that the inteirrity (jf the uterine canalas a natural drainauc-tuhc is essential to health. Rem
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