The diseases of women : a handbook for students and practitioners . n ofthe patient, in the details of the operation, and in the aftertreatment. Perineorrhaphy may be described in two sections : 1. When the laceration is partial; 2. When the laceration is complete. Preparation of the Patient.—To ensure success it is ne-cessary that the patient be confined to bed for a few days,and her bowels should be thoroughly and regularly evacu-ated. The vagina is douched twice daily with a solutionof permanganate of potash, and if there be a purulentdischarge from vagina or cervical canal, this should bet
The diseases of women : a handbook for students and practitioners . n ofthe patient, in the details of the operation, and in the aftertreatment. Perineorrhaphy may be described in two sections : 1. When the laceration is partial; 2. When the laceration is complete. Preparation of the Patient.—To ensure success it is ne-cessary that the patient be confined to bed for a few days,and her bowels should be thoroughly and regularly evacu-ated. The vagina is douched twice daily with a solutionof permanganate of potash, and if there be a purulentdischarge from vagina or cervical canal, this should betreated thoroughly before any attempt is made to repairthe perineum. Instruments required in addition to those enumerated on p. 338: Scissors, angular and flat; haemostatic forceps; silkworm 341 342 DISEASES OF WOMEN. gut; silver wire; perforated shot and coils; needles inhandles; shot-compressor. Partial laceration of the Perineum.—The patientis fixed in the lithotomy position, and the operator intro-duces the first two fingers of the left hand into the anus,. Fig. 99.—Perineorrhaphy : first stage, the raising of the flap (Fancourt Barnes). so as to put the parts in front on the stretch. With a pairof sharp-pointed angular scissors the vaginal mucous mem-brane is raised up as a flap by splitting the recto-vaginalseptum, and the flap is carried up on each side as far as theoriginal limit of the perineal body (Fig. 99). No attempt is made to arrest the bleeding, but the assist- OPERATIONS ON PERINEUM, VULVA, AND VAGINA. 343 ant keeps the field of operation clear by repeated applica-tion of a sponge or moistened cotton-wool dabs. Careshould be taken not to buttonhole the vaginal flap while itis being raised. As soon as the flap is sufficiently raised, it is held up bythe assistant with a pair of forceps whilst the sutures are
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