Transactions of the American Association of Obstetricians and Gynecologists for the year ... . Fig. io.—Two or three rounds of continuous or interrupted sutures are placedin the levator alone, and tied. All succeeding rounds catch, in addition enoughof the submucous areolar tissues from the bottom and top of the wound to oblit-erate dead spaces, and to adjust the vaginal flap in smaller folds overhead. knot tied in it. Each of these stitches carefully takes a substantialgrasp of the lateral bearing structures, notably of the trigone; thisobliterates the wound cavity and stops the venous bleedi
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . Fig. io.—Two or three rounds of continuous or interrupted sutures are placedin the levator alone, and tied. All succeeding rounds catch, in addition enoughof the submucous areolar tissues from the bottom and top of the wound to oblit-erate dead spaces, and to adjust the vaginal flap in smaller folds overhead. knot tied in it. Each of these stitches carefully takes a substantialgrasp of the lateral bearing structures, notably of the trigone; thisobliterates the wound cavity and stops the venous bleeding by re- 138 A. GOLDSPOH N , peatedly but gently picking up the areolar submucous tissues in thebottom of the wound, as well as on the under surface of the vaginalflap which, thereby, becomes adjusted in small ruffles as a fastenedcovering of the newly constructed rectovaginal septum. The vag-. Fig. ii.—Shows incision in vaginal mucosa. From its inner edge ,a flap is raised to restore the pelvic floor; and from its outer edge , the flapis dissected outward for the plastic upon the rectum and anus inal flap, thus arranged in small folds and fastened to the unitedbearing structures beneath it, produces a more massive and durableseptum than could be obtained if it were cut away. Of this puckeredflap a small tip only is cut away; and then an interrupted silkworm, LACERATIONS OF THE PERINEUM. 139 or chromic catgut, stitch is placed which takes in the adjacentsides of the skin wound and the ruffled edge of vaginal flap, in themanner of a purse string. The remaining skin wound is closed withsimilar interrupted stitches, or in a subcuticular manner, as may be
Size: 1374px × 1819px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1900, booksubjectgynecology, booksubjectobstetrics
