. A manual of gynæcology and pelvic surgery, for students and practitioners. ds are all based on the flap-splitting principle andare sufficiently represented by the following, which is entirelysatisfactory. SPLIT-FLAP OPERATION With a sharp knife the margin of the recto-vaginal septum isfirst spHt transversely to a depth of at least i cm. This pro-vides a vaginal flap and a rectal flap at the apex of the end of this incision is then prolonged through the scartissue along the lateral vaginal wall on either side of the cloacaand at least J^ cm, from the rectal mucosa, the incision term
. A manual of gynæcology and pelvic surgery, for students and practitioners. ds are all based on the flap-splitting principle andare sufficiently represented by the following, which is entirelysatisfactory. SPLIT-FLAP OPERATION With a sharp knife the margin of the recto-vaginal septum isfirst spHt transversely to a depth of at least i cm. This pro-vides a vaginal flap and a rectal flap at the apex of the end of this incision is then prolonged through the scartissue along the lateral vaginal wall on either side of the cloacaand at least J^ cm, from the rectal mucosa, the incision termi-nating at the skin on either side. The first incision is thus com-pleted as an inverted U, the convex end of which is situated in 154 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM the recto-vaginal septum above, the legs of the U extendingthrough the scar at either side to the skin. From each end of this incision, that is at the junction ofvaginal mucosa and skin and at right angles to it, a short antero-posterior cut is made. The anterior end of this last incision is I. Fig. 67.—Secondary repair of complete laceration of of incisions. on a level with the remnant of the lower hymeneal posterior end extends just through the dimple representingthe retracted end of the sphincter ani. Reference to the figure will show that two flaps are now out- PERINEORRHAPHY FOR COMPLETE LACERATION 15s lined upon either side. By dissecting up each anterior flap tothe extent to which it is covered by cicatrix, tissue for the newposterior vaginal wall is furnished. By dissecting and turningbackward the posterior flaps to the extent to which they are
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Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
