File:Tri-State medical journal (1895) (14582740528).jpg

Identifier: tristatemedicalj2189ball (find matches)
Title: Tri-State medical journal
Year: 1895 (1890s)
Authors: Ball, James Moores, 1863-1929
Subjects: Tri-State Medical Society Medicine
Publisher: St. Louis : (s.n.)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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ing due precautions to procure asepsis. Two or three assistants should be called. Two volsellae, two retractors, Hagedorn needle and holder, Kelly pad, or an improvised waterproof sheet, complete the necessary paraphernalia-Drawing the patient on the edge of the bed or table, her legs are supported on the shoulders of two assistants, with one person competent to administer the anaesthetic, thus completing the necessary arrangements for the immediate 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, in the great majority of cases, will be found if the vagina is thoroughly cleansed 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 rents of the spincter ani and recto-vaginal septum.
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FIGURE 1. Cut number one represents a slight perineal laceration with expansion of the floor of the.vagina, causing s;l,ght reetoce.le, 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 operated upon, 195 were lacerati

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