. Tri-State medical journal . ing due pre-cautions to procure asepsis. Two or three assistants should be volsellae, two retractors, Hagedorn needle and holder, Kelly pad, oran improvised water-proof sheet, complete the necessary paraphernalia-Drawing the patient on the edge of the bed or table, her legs are supportedon the shoulders of two assistants, with one person competent to administerthe anaesthetic, thus completing the necessary arrangements for the imme-diate operations. 322 Perineo-Plasty-Mayfield. After the sutures are taken the hemorrhage due to laceration ceases and kute
. Tri-State medical journal . ing due pre-cautions to procure asepsis. Two or three assistants should be volsellae, two retractors, Hagedorn needle and holder, Kelly pad, oran improvised water-proof sheet, complete the necessary paraphernalia-Drawing the patient on the edge of the bed or table, her legs are supportedon the shoulders of two assistants, with one person competent to administerthe anaesthetic, thus completing the necessary arrangements for the imme-diate operations. 322 Perineo-Plasty-Mayfield. After the sutures are taken the hemorrhage due to laceration ceases and kuterine contractions begin. The vagina is dried and filled with iodoformgauze. Then the physician is prepared to attend to the perineal tear, which, inthe great majority of cases, will be found if the vagina is thoroughlycleansed and dried. I cannot urge too strongly the importance of performing the perineor-rhaphy, from the slightest tear of the fourchette to the most extensive rentsof the spincter ani and recto-vaginal FIGURE 1. Cut number one represents a slight perineal laceration with expansion of the floor of , causing s;l,ght , the extent of the tear being clearly shown by the cicatrix. It is well to call attention to the not infrequent instances of subcuta-neous rupture of the muscular tissue and fascia of the perineum, relaxingand widening the pelvic floor, thus destroying the perineal support whiletthe skin and mucous surfaces show no tear at all. Such so-called concealedruptures should be brought together by two to four-inch-deep perinealstitches. The repair of the ruptured perineum immediately after the acci-dent is comparatively easy; but, alas, it is too often allowed to go unnoticed Original Articles. 323> for months and years, until development of nervous phenomena drives thepatient from home for relief. The rules for doing perineorrhaphy are practically the same as thosefor perineo-plasty after denudation. Of the 331 cases I have op
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Keywords: ., bookcentury1800, bookdecade189, booksubjectmedicine, bookyear1895
