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In 1887 Dr. Hadra of Texas contributed some valuable articles on the subject of perineorrhaphy. He suggested vivisection of the posterior vaginal wall for colporrhaphy, as is done in anterior colporrhaphy. Since 1880, the laborers in the field are legion. Gradually the operation of perineorrhaphy was modified from Paré, Baker-Brown, Dieffenbach, Langenbeck and Simon to Tait and Emmet. The modification consisted in denuding not only the perineal tears, but also denuding higher up in the posterior vaginal wall. Hildebrandt especially carried the denudation well up into the posterior vaginal wall.
As regards suture material, Sims, Thomas, Emmet and others worked out the application of metallic wire to plastic labors on the perineum during the past thirty years. The modern tendency is to use silkworm gut as a non-absorbable suture. This may be left weeks in a wound, and acts as a splint in coapting the surfaces. It is easy to
ROBINSON B. COLPOPERINEORRHAPHY AND THE STRUCTURES INVOLVED.. JAMA. 1898;XXXI(14):782-788. doi:10.1001/jama.1898.92450140036001p