A system of gynecology . oss of tissue from sloughing, failures may arisefrom the cicatricial character of the parts or from difficulty in holdingthe edges together. Perineorrhaphy in very fat subjects, especially whenthe rupture extends through the sphincter ani muscle, may fail afterthe most skilful operation, but generally the conditions of success arewithin the control of the operator. These conditions are simple butabsolute, and the operator who has neglected them cannot fairly attributehis failure to the debilitated state of the patient or to chance or to acci-dent. Indeed, union must al
A system of gynecology . oss of tissue from sloughing, failures may arisefrom the cicatricial character of the parts or from difficulty in holdingthe edges together. Perineorrhaphy in very fat subjects, especially whenthe rupture extends through the sphincter ani muscle, may fail afterthe most skilful operation, but generally the conditions of success arewithin the control of the operator. These conditions are simple butabsolute, and the operator who has neglected them cannot fairly attributehis failure to the debilitated state of the patient or to chance or to acci-dent. Indeed, union must almost invariably follow if the surface- tobe united are properly prepared and kept in contact for a week. Thefirst condition, antisepsis, lias been discussed. The others will be pre-sented in the following paragraphs. Denudation.—The patient having been etherized, placed in posi-tion, and the field of operation exposed, the surfaces to be unitedshould be denuded. Correct denudation is a prerequisite to healing Fig. iHimdatiun with thr Tenaculum nnd Scissors. by first intention. Surfaces to be united should be so denuded thatwhen brought together they will fit accurately, otherwise a part of thedenuded surface, being in contact with an undenuded surface, must heall>v granulation and suppuration, which may excessively irritate the restof the wound, and would always produce cicatricial tissue, which is very PLASTK OPERA TIONS. ..47 Fig. 14«).A objectionable. The denuded surface should be smooth and tree fromshmls, which might die and become sources of septic infection. Everyparticle of membrane or skin within the area of denudation should bescrupulously removed, li the surface l>e perfectly healthy, the moresuperficial the denudation the better, but diseased and cicatricial tissuesdo not readily unite, and should therefore, when practicable, be Fi<i. 14S shows the action of the tenaculum and scissors in superiority of the tenaculum as a subs
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectwomen, bookyear1887
