The practice of surgery . peration is applicable to slight tears only. The dis-section does not reach the deep parts, so that the result, though pre-senting a seemh^ cosmetic scar, is of little value as a perineal supportand yields at once in the case of a subsequent labor. Nobles operation also is based on the principle of denudation, butthe dissection is carried further, as shown by the illustration, so that anadmirably strong perineal support is secured. PERINEAL LACERATIONS 351 Among the well-known operations on the perineum are those ofMartin, Dudley, Cleveland, Garrigue, Outerbridge, Ree
The practice of surgery . peration is applicable to slight tears only. The dis-section does not reach the deep parts, so that the result, though pre-senting a seemh^ cosmetic scar, is of little value as a perineal supportand yields at once in the case of a subsequent labor. Nobles operation also is based on the principle of denudation, butthe dissection is carried further, as shown by the illustration, so that anadmirably strong perineal support is secured. PERINEAL LACERATIONS 351 Among the well-known operations on the perineum are those ofMartin, Dudley, Cleveland, Garrigue, Outerbridge, Reed, Goldspoon,and others. The after-treatment for all these operations is of great consists of rest in bed for at least sixteen days, careful regulationof this bowels, and painstaking care of the wound, as after a bowels should be moved with an oil enema on the second or thirdday. If the patient voluntarily passes urine, the parts should be cleansedwith an aseptic douche after each Fig. 220.—Nobles operation for repair of perineum. The stitches may be removed on the tenth day. At the end of twoweeks the patient may sit up in bed, but should not be allowed tostand until the expiration of three weeks. After the bowels have moved,a liberal diet may be allowed, with the use of laxatives or enemata toinsure a comfortable daily evacuation of the rectum. Lacerations of the perineum hold so conspicuous a place in the sur-gery of these parts that students often overlook a consideration of otherlocal surgical lesions. There are sundry other such lesions, moreinfrequent than perineal rupture, but often distressing and important 352 FEMALE OUGAXS OF GEXERATION to the sufferer. These are wounds, fistula, tumors, cysts, and the lesionsof venereal disease. A common and apparently trifling disturbance isurethral caruncle. URETHRAL CARUNCLE This is an outgrowth at the orifice of the urethra. There are twoforms of caruncle—the first is a capillary an
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
