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After employing the old method of operation for the repair of laceration of the perineum in something more than fifty cases, I became satisfied that some method might be devised whereby the patient would be subjected to less suffering, and the surgeon less uneasiness respecting the results. The chief cause of pain always seemed to be a swelling of the tissues from the strangulation induced by the wire sutures, which was frequently increased by more cr less cutting of the skin in spite of the nicest care in the adjustment of the sutures and avoidance of unnecessary strain. I noted that some of our best operators, in their writings upon the subject, referred to this swelling as a necessary result of the operation, and regarded opiates in some form as on this account necessary in the management of cases of this sort. This led me to believe the swelling to
KELLOGG JH. A NEW FORM OF SUTURE PIN FOR USE IN PERINEORRHAPHY. JAMA. 1887;IX(21):654. doi:10.1001/jama.1887.02400200014001f
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