Lawson Tait's perineal operations, and an essay on curettage of the uterus / by W.J. Stewart McKay.

  • McKay, W. J. Stewart (William John Stewart), 1866-1948
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Lawson Tait's perineal operations, and an essay on curettage of the uterus / by W.J. Stewart McKay. Source: Wellcome Collection.

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    well in towards the median line, while one of the assistants makes gentle traction on the anal flap, A F. Each suture is tied in turn, and'when everything is finished Fig. 16 shows the state of the parts. The posterior vaginal mucous membrane in this operation is formed, by dissection, into a flap, and when the hooks are taken off after the operation this flap falls against the anterior surface of the newly-made perineum, to which it adheres and which it helps to strengthen. The anal flap, A F, becomes smaller each day after the operation, and] by adhering, also becomes an integral part of the newly- formed perineum. AFTER-TREATMENT. After completing the operation, the parts are dusted with iodoform and boracic acid powder; some dressings and a T-bandage are applied. [I do not apply any dressings, but direct the nurse to keep the parts quite dry.—L. T.] The patient's legs should be tied together until she has regained consciousness, else she may struggle and put great tension on the sutures. The bowels should be washed out every day by a simple enema, and no hard faeces should be allowed to accumulate. We generally syringe the external genitals with Condy's fluid twice a day ; and if any bleeding takes place from the vaginal flap, the vagina may be syringed. The only complications which arise are occasional stitch abscess, and very exceptionally some slight haemorrhage from the vaginal flap. We have had the latter complica- tion once, and we know that it has occurred to others. Hot injections or plugging the vagina with iodoform gauze will be all that will be necessary in such a case. Should a stitch abscess form, it is generally due to the suture having been passed through the rectal mucous