. The diagnosis and treatment of diseases of women. from the vagina into the peritoneal cavity, is removed usuallyin three or four days Occasionally when the gauze extends far in, as for examplein the Wertheim operation, it is preferably removed a little each day on the fourth. 782 AFTER-TREATMENT IN OPERATIVE CASES fifth and sixh day. After removing gauze, if there is much of a cavity, it is ad-visable to replace the gauze in the vaginal incision, to keep it open until the cavityis nearly closed by granulation. In the case of an abscess cavity, a rubber tube,arranged as previously explained (
. The diagnosis and treatment of diseases of women. from the vagina into the peritoneal cavity, is removed usuallyin three or four days Occasionally when the gauze extends far in, as for examplein the Wertheim operation, it is preferably removed a little each day on the fourth. 782 AFTER-TREATMENT IN OPERATIVE CASES fifth and sixh day. After removing gauze, if there is much of a cavity, it is ad-visable to replace the gauze in the vaginal incision, to keep it open until the cavityis nearly closed by granulation. In the case of an abscess cavity, a rubber tube,arranged as previously explained (Figs. 633, 634), is preferable. After the gauze is left out of the vagina, a cleansing douche of normal salinesolution or an antiseptic solution, is given once or twice daily, depending on theamount of discharge. After a vaginal or perineal operation, the vulva and adjacent surfaces must bekept covered with an antiseptic dressing, the same as any other wound , however, on account of the necessity of evacuation of the bowel and bladder,. Fig. 697. Cleansing the External Genitals. The use of the Pitcher-douche. the problem of wound protection is more complicated. The dressing must bechanged several times daily and with each change of dressing there is danger ofcontamination. When it is necessary to change the dressing, the nurse should disinfect her handsand then cleanse the operative field with an antiseptic solution (e. g. bichloride1-5000). This cleansing may be conveniently accomplished by means of thepitcher douche (Fig. 697). After the cleansing, a fresh dressing is put on andthe T-bandage again applied (Fig. 698). If the patient can pass the urine she should ordinarily be permitted to do so,whatever the character of the vaginal work. Catheterization is more likely to doharm than urination, especially as the urine remaining on the genitals is at once AFTER VAGINAL OPERATIONS 783 removed by the cleansing solution. To aid spontaneous urination, hot packs onthe vulv
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