A textbook of obstetrics . r comfort subse-quently ( liar). four hours of its occurrence. The simplest way to sew up a lacerated perineum that does not involve the sphincter ani isshown in figure 430. All that is needed for the operation is acurved needle set upon a handle and a few strands of silk- LABOR COMPLICA TED BY ACCIDENTS AND DISEASES. 56 l worm gut. The suture material and the needle .should be im-mersed in boiling water for five to ten minutes before they areused. Tlie woman is kept in the dorsal position across the bed ;the thighs are well Hexed and widely separated, the feet resti
A textbook of obstetrics . r comfort subse-quently ( liar). four hours of its occurrence. The simplest way to sew up a lacerated perineum that does not involve the sphincter ani isshown in figure 430. All that is needed for the operation is acurved needle set upon a handle and a few strands of silk- LABOR COMPLICA TED BY ACCIDENTS AND DISEASES. 56 l worm gut. The suture material and the needle .should be im-mersed in boiling water for five to ten minutes before they areused. Tlie woman is kept in the dorsal position across the bed ;the thighs are well Hexed and widely separated, the feet restingupon chairs. The operator inserts the forefinger of his left handin the rectum and measures the depth and extent of the tearwith his thumb in the vagina. The needle is then plungeddeeply into the pelvic muscles, so that it encircles the woundthroughout its whole depth and emerges on the opposite sidenear the upper margin of the tear. The eye is threaded by anassistant, and the needle is then withdrawn. This suture is re-. Fig. 436.—An efficient and simple method for the primary repair of laceration of theperineum and of the pelvic floor. peated from three to six times, according to the extent of thetear. If care is taken to insert the needle deeply enough, andto put the first stitch near the upper margin of the tear through-out its whole depth, a thoroughly satisfactory and strong unionof the parts can be secured by an operation of the simplest pos-sible nature, easy for the veriest tyro in surgery to perform, andlasting not more than five minutes. Another plan to be recom-mended in tlie hands of experts accustomed to gynecologicalsurgery is to sew up the lacerated perineum and torn vagina inthe same manner that one inserts stitches for the secondaryoperation upon the perineum, after the plan ^{ Emmet. If theperineum is torn through the sphincter into the rectum, the best36 562 111E OF LA/>OR.
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
