Recent improvements in the operative treatment of vesico-vaginal fistula / by J. Clarence Webster.

  • Webster, John Clarence, 1863-1950.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Recent improvements in the operative treatment of vesico-vaginal fistula / by J. Clarence Webster. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Dissect a small oval flap of vaginal mucosa, | in. or f in. in diameter, from the anterior wall of the vagina, the fistula being in the centre of the flap. Fig. 2. a. Raw surface with fistula in its centre, and first stage of continuous suture. b. Appearance of vaginal wall after closure of raw surface. Then, with a continuous catgut suture, applied in two or three stages, close the raw surface until only a longitudinal wound is left. In this way the fistula is covered by a thick mass of vaginal tissue. 2. Small or medium-sized Jistulce, in which there has been no loss of tissue, and whose edges may be approximated fairly closely. Here it is not a good principle to remove a strip of tissue, as recommended by Sims and Simon. Every gynecologist has had experience of ill-success by the use of their methods in these cases. Sometimes this is due to too great tension on the stitches. Sometimes, in fear of this danger, too small an amount of tissue is removed, so that either non-union or only partial union results. In successive attempts, new raw surfaces are obtained only by renewed paring of the edges. Such cases may require five, six, or more operations before permanent cure can be effected.