File:Tri-State medical journal (1895) (14789257273).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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e removed and perfect union is almost always obtained. hand, I make a deep incision from \ inch to f inch, entirely through thelabium major on both sides, cutting entirely through the vaginal tissues,then from one incision to the other a superficial incision is made upon theposterior vaginal wall as far up as the cicatricial tissue extends—then de-nude the surface of all the scar tissue, posterior to the rectum. To close the rectal tear I use a short curved needle armed with catgut, 328 Perineo-Plasty-Mayfield. and as Emmet suggests, put in the sphincter stitches and bring togetherthe denuded ends of the torn muscle, knotting each stitch as I go fromabove down. The threads are drawn into the rectum and tied and left undippedhanging out of the anus. This gives a fresh wound in the shape of a dia-mond with the obtuse angles at the lateral incisions. Over this area a stream of sterilized water plays while with a longcurved needle armed with strong braided silk, I take the great primary
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FIGURE 7. stitch, upon which has hung the success of this operation in 331 cases—introducing the needle at the left incision \ inch external to the peripheryof the wound, I circumscribe the superior boundry, bringing the needle outat a point opposite its entrance. My assistant holding the ends of thethread well up, the other stitches, which are of silkworm gut, are intro-duced, then bringing the edges of the whole area into perfect apposition, Original Articles 329 the threads are tied, beginning with the primary. For dressing, collodiumis applied. On the ninth day the patient is brought to the office and the stitches areremoved, exposing a result of perfect union of all the parts. The advan-tages of this operation over those of Tait, Emmet, Bergmann and othersare summed up as follows: 1st. It does away with all cicatricial tissue, which I believe to be thecause of a second laceration, and of much harm to the perineal function. 2d. It renders unnecessary the adduction of the limbs,

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