Interstate medical journal . Plate 2. the number of sutures in the tract being regulated by its length. (The anchorsuture is removed as the invagination is completed.) After the entire tract has been invaginated, several buried catgut sutures RADICAL CURE OF VESICO -VAGINAL FISTULA. 251 are placed at the end of the tract. (Plate 5.) These include the connectivetissue at the base of the invaginated portion. The invagination of the tract isgreatly facilitated by making tension on the vaginal anchor sutures (Plate 4-D. Plate 4. and C) which were placed before the invaginating sutures (Plate 4 F)
Interstate medical journal . Plate 2. the number of sutures in the tract being regulated by its length. (The anchorsuture is removed as the invagination is completed.) After the entire tract has been invaginated, several buried catgut sutures RADICAL CURE OF VESICO -VAGINAL FISTULA. 251 are placed at the end of the tract. (Plate 5.) These include the connectivetissue at the base of the invaginated portion. The invagination of the tract isgreatly facilitated by making tension on the vaginal anchor sutures (Plate 4-D. Plate 4. and C) which were placed before the invaginating sutures (Plate 4 F) wereplaced. The denuded surface in the vagina is closed with interrupted silkwormgut sutures, the line of sutures being on a vertical plane, as suturing in this di- 252 AMYX , rection gives a better support to the underlying buried tissues. The sutureswhich pass through the urethra are fastened on the pubes with adhesive plaster.(Plate 5-F.) The above described method is referable to small and medium sized fistula?.In large openings of one-half to one inch diameter I would recommend that thedissection of the circular vaginal flap should commence at a point one-half inchfrom the edges of the opening of the fistula. This will provide for a tract longenough for invagination and with freshly exposed surface for a closure of thefistula. The technique is the same as that described above, excepting that thevaginal flap, is considerably wider. The after-treatment consists of inserting a retainable soft rubber cathet
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectmedicine, bookyear190
