Surgery; its theory and practice . d, the childbeen weaned, and the generalhealth Restored. The patient inthe meantime should not beallowed to walk about, for fearof a prolapse of the parts. Theoperation consists in refreshingthe sides of the rupture, anduniting them by suture. Thebowels having been cleared byan aperient, and the rectum onthe morning of the operation byan enema, the patient should beplaced in the lithotomy position,and the skin dissected off from the sides of the fissure, and the mucous membrane from the recto-vaginal septum, so as to leave a raw surface of the size and shapes
Surgery; its theory and practice . d, the childbeen weaned, and the generalhealth Restored. The patient inthe meantime should not beallowed to walk about, for fearof a prolapse of the parts. Theoperation consists in refreshingthe sides of the rupture, anduniting them by suture. Thebowels having been cleared byan aperient, and the rectum onthe morning of the operation byan enema, the patient should beplaced in the lithotomy position,and the skin dissected off from the sides of the fissure, and the mucous membrane from the recto-vaginal septum, so as to leave a raw surface of the size and shapeshown in Fig. 152. The skin and mucous membrane should notbe cut away as shown in the figure, but reflected towards thevagina. Care should be taken that the tissues are clean cut, andthat the raw surface of the recto-vaginal septum is at least an inchbroad, so that immediate and firm union when the parts arebrought together may be obtained. Three or more deep sutures,consisting of thick silver wire, strong silkworm-gut, or China17*. Operation for ruptured perineum. 402 INJURIES OF REGIONS. twist, should be introduced by means of a perineal needle. Thefirst should be passed about an inch from the margin of the rup-ture deeply through the recto-vagmal septum, and out at thecorresponding spot on the opposite side. The next two suturesshould be passed in the same way, only not through the 152 shows the appearance presented by the sutures when insitu and ready for tying. They may be fastened over a piece ofquill or by split shot, or simply tied, the posterior suture beingfirst secured. Superficial sutures, after the fissure has been drawntogether by the deep, should be used to keep the edges of theskin in contact. If there appears to be any tension, incisionsof relief may be made through the skin on either side. Thereare many modifications of this operation, but for the sake ofclearness only the most simple method has been here bowels must be kept confined f
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
