Operative surgery . low, aud fastened in place with sutures () addressed to the contiguous borders. ^ The remaining raw surface (c) is permitted toheal by granulation, or repaired by skin graft-ing. The Iiouarks.—A proper interval shouldelapse between each stage of the operation, toallow of complete repair of the preceding stepsand a suitable estimate of their success. Formerly Thiersch established a temporary perinealfistula, but he has since decided tliat with propercare it need not be made. Duplays Method.—In Duplays, as in the pre-ceding method, the operation is divided into fourst
Operative surgery . low, aud fastened in place with sutures () addressed to the contiguous borders. ^ The remaining raw surface (c) is permitted toheal by granulation, or repaired by skin graft-ing. The Iiouarks.—A proper interval shouldelapse between each stage of the operation, toallow of complete repair of the preceding stepsand a suitable estimate of their success. Formerly Thiersch established a temporary perinealfistula, but he has since decided tliat with propercare it need not be made. Duplays Method.—In Duplays, as in the pre-ceding method, the operation is divided into fourstages: The fir fit stage is allotted to the straighteningof the penis, which is done in the manner alreadydescribed (page l-23T). The Second Stage.—In the second stage theurethra is formed and entirely (Fig. 1484) fromthe central, :r, ./•, penile structures. A strip of tissue about a quarter of an inch in width is freshened at eachside of the urethral gutter («, a), and the freshened surfaces are united with. Fig. 1484.—I)uplays methodof operation for epispadias,second stage, a, a. Fresh-ened surfaces, z. Fistulousopening.
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