File:Manual of operative surgery (1921) (14597987468).jpg

Identifier: manualofoperativ1921binn (find matches)
Title: Manual of operative surgery
Year: 1921 (1920s)
Authors: Binnie, John Fairbairn, 1863-1936
Subjects: Surgery, Operative
Publisher: Philadelphia : Blakiston
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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osterior part of the cutaneous wound.Close the extensive skin wound with sutures after providing, where necessary,for drainage. N.B.—When removing the scrotum it is well to leave enough of its pos-terior wall to be brought forward and upward and united to the edge of thewound across the pubis. When this is done the urethra can be brought througha button-hole cut in the base of the scrotal flap (Fig. 903). When removingthe scrotum v. Dittel retained a portion of the posterior scrotal skin whichhe wrapped around the stump of the corpus spongiosum (left long for this pur-pose). The effect of this detail was the formation of a sort of spout whichenabled the patient to urinate without taking down his trousers. CHAPTER LVCIRCUMCISION There are several methods of performing circumcision; most of these aremerely modifications of the following: Classical Method.—Feel an(i locate the corona or groove behind the glanspenis; the prepuce being in normal position is not retracted. Place a clamp
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Fig. 904. Figs. 904 and 905 Circumcision. (the handles of a long scissors form an efficient clamp) on the skin correspond-ing to the corona. Gently tighten the clamp so as to hold the skin betweenits blades and yet permit the glans to be pushed back behind it. Push backthe glans so that it lies in safety behind the clamp. Tighten the grasp ofthe clamp. The whole skin and part of the mucous membrane of the prepuce 47 738 CIRCUMCISION now lie in front of the clamp; the glans and part of the mucous membraneof the foreskin lie behind it. Remove, with a knife, all the structures in front of the clamp. Remove theclamp. The skin retracts to the root of the penis; the glans is covered by a tubeof mucous membrane having a raw and bleeding external surface. Cut away(Fig. 904) all except about 3^ inch of the mucous membrane. If the frenumis short and pulls the glans downwards and backwards, divide that structuretransversely and in suturing convert the transverse into a longitudinal wound,thus le

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