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The third danger in the operation for vaginal atresia that septic infection, which has caused death in many cases with symptoms exactly like those puerperal fever.
Several gynecologists have preferred to divide the atresia with the thermo-cautery, thinking protect the surface the wound from infection the eschar more thoroughly than means the ordinary antiseptic measures. It very evident that this could pay to write a paper only done with very accessible or narrow atresias, such as atresia hymenalis or retro-hymenalis Duncan, or with lateral hgematokolpos Neugebauer. For in cases where the guidance the fingers indispensable, and where work in the immediate vicinity bladder, rectum, and peritoneum, some instrument which not red hot must employed. In suitable cases the method has been successful enough but according to experience, can dispense with entirely.
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The electrolytic action the constant current has also been tried. Lefort reports that thus succeeded in making an artificial passage through a vaginal atresia, on which ten previous operations had been tried in vain.
He passed a copper wire into the funnel-shaped blind sac, which was long, and applied the constant current. He says that menstruation thereupon appeared regularly, the speculum could introduced, and the portio seen. Several essay writing services online the older observers thought that the entrance air and the decomposition the retained blood was the cause the infection. Vidal claimed as the cause the entrance air the previous dilatation the uterus, which was then unable close. Scanzoni also calls attention the danger a septic endometritis, caused the entrance air Clarke, who believes that rupture the tubes caused ulceration, fears the entrance air, lest start the destructive rocess, and seeks prevent the exhibition secale and turpentine.
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It undeniable that the decomposition the stagnating menstrual blood which left behind, much more often the cause septic endometritis and pelviperitonitis than the direct infection the wound during the operation explainable perhaps in that the bacteria find a very suitable nutriment in the decomposing semrfluid matter.
Infection during and after the operation will avoided the general care in regard the minute cleanliness instruments and the fingers which now the rule. When necessary may disinfect the entire seat operation, use the spray, and avoid all untrustworthy dressings and afterwards frequently change the dressings after having steeped them in an antiseptic fluid.
As the entrance air into the retention-cavity, later experience has shown that its danger depends upon whether has been disinfected or not the contact even hospital air, which has been made aseptic by means a carbolic or salicylic spray, being innocuous. Nevertheless, it advisable in places where an efficient drainage difficult obtain, to prevent the entrance air as much as possible. Sims, Schatz, and Hegar have studied the conditions upon which depend the entrance of air. Schatz has especially made clear that the pressure-relations fast custom essays within the pelvis, whether the patient in the knee-elbow, in Sims's, or in any other position, changed as soon as any organs which occupy the true pelvis are lifted out Since the bony walls will not give way, as soon as the pressure sinks below that the atmosphere air thesis guidelines will enter if allowed When the elevated and dilated organs, the uterus and the vagina, cannot sink down masse after evacuation, as prevent a negative pressure in the pelvis, air will rush in through the gaping wound. This may occur any operation, but especially liable happen when use the trocar and canula. In fact the change in shape and position the emptying sac often an insufficient one and this account not only the pseudo-membranous fixation the uterus and tubes, but perhaps oftener because the hypertrophy and dilatation the collum uteri, and that portion the vagina which lies above the atresia. It therefore, advisable not elevate the patient's pelvis too much and in narrow, septum-like atresias not keep the orifice open with the knife, until the pressure the fluid has sunken that ceases flow. We cannot make use the ordinary measures prevent the entrance of air when puncturing, because not employ dissertation editing services the simple puncture with the trocar. When absolutely necessary, as in broad atresias, leave the canula in situ, must use antiseptic injections and see that there is a free outflow for the entrance air and the decomposition the secretion which left behind unavoidable. At least should attempt to disinfect the entering air as much as possible, packing the end the canula in disinfectant absorbent cotton or gauze if short canula? which not project from the vagina are employed, closing the external genitals with an antiseptic pad.
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