. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 44.—Repair of recent small incomplete midline laceration. If thewound extends high in the vagina sutures on the vaginal surface are should penetrate to the bottom of the wound. to prevent infection and more extensive injuries to secure areturn to normal of the functions of the involved muscles. The small median laceration is repaired by inserting as manysutures from the skin surface as may be required to secure 128 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM coaptation. Usually but two or three a
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 44.—Repair of recent small incomplete midline laceration. If thewound extends high in the vagina sutures on the vaginal surface are should penetrate to the bottom of the wound. to prevent infection and more extensive injuries to secure areturn to normal of the functions of the involved muscles. The small median laceration is repaired by inserting as manysutures from the skin surface as may be required to secure 128 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM coaptation. Usually but two or three are needed for thispurpose but they should pass to the bottom of the wound. Ifthe wound extends too high in the vagina for satisfactoryclosure in this manner, one or two sutures on the vaginal surface. Fig. 45. -Repair of recent small incomplete midline perineal laceration,sutures are tied and approximate depths of wound. Skin are necessary. If the stitches are passed very soon after de-livery no anaesthetic is required. The immediate repair of complicated lacerations, those ex-tending into the vaginal sulci or passing through the recto-vaginal septum, should be viewed as a distinct surgical operationto be carried out under thorough aseptic precautions, in a good I I COMPLICATED LACERATIONS 129 light, and with plenty of assistance. An anaesthetic is neededunless the patient has unusual fortitude. The hurried repairof bad perineal tears immediately after delivery, and while thepatient and attendant are both exhausted, needs only be men-tioned to be condemned.
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