. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 62.—Secondary repair of incomplete perineal laceration by split-flapmethod. The posterior commissure is split transversely. Split-flap Perineorrhaphy.—As originally practised by Taitthis operation had little more than a cosmetic effect, but on itsprinciple is based an operation which combines the advantages 148 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM of the Hegar in narrowing the vagina, the Emmett in elevatingthe anus, and has merits of its own in securely joining thelevators of either side between the vag
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 62.—Secondary repair of incomplete perineal laceration by split-flapmethod. The posterior commissure is split transversely. Split-flap Perineorrhaphy.—As originally practised by Taitthis operation had little more than a cosmetic effect, but on itsprinciple is based an operation which combines the advantages 148 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM of the Hegar in narrowing the vagina, the Emmett in elevatingthe anus, and has merits of its own in securely joining thelevators of either side between the vagina and Fig. 63.—Secondary repair of incomplete perineal laceration by split-flapmethod. The vaginal flap is raised and dissected from the rectum by the fingercovered with gauze. Taits original operation consisted in separating the posteriorvaginal wall from the skin of the perineum by a transverse SPLIT-FLAP PERINEORRHAPHY 149 ncision made with scissors, elevating the vaginal flap, deepening^he incision to the extent of 3 or 4 cm., and uniting the wound byjutures placed transversely. The flap thus elevated was not•emoved. The result was merely to unite the split perineal)ody whose muscles are relatively unimportant, leaving the j£ ^^ -m^ ^^ ^^ ^M ^(Mb ^^^p^ \ ^^^^Sv ^^1 W^^ \ \ \ ? -^-^# \ y Fig. 64.—Secondary repair of incomplete perineal laceration by split-flapnethod. Suture catching edge of levator. Dotted line for removal of super-luous flap. ;rue supporting structures of the pelvic floor as they were)efore operation. If, however, the deep dissection is carried sufliciently hig
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