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In May, 1893, I was called to Milford by Dr. Wm. J. Clarke, to repair a complete rupture of the perineum, which occurred in the practice of a neighboring physician one week before. I found the levator ani and both sphincters torn, with liquid feces coming from the rectum, while pus flowed from, the wound. The condition was such as seemed to render primary union impossible, but by means of washing, scraping refreshing and defining the ragged edges of the skin and mucous membrane and bringing the denuded surfaces into close apposition with buried sutures, the result was perfect with first intention throughout. The long delay after the accident, combined with the condition of the wound and the subsequent perfect result of the treatment, brought up a line of thought which I have since pursued with advantage in the primary repair of the injuries of parturition.
The immediate repair of
TUTTLE AH. THE INJURIES OF PARTURITION, THE TIME, METHOD AND REASONS FOR THEIR REPAIR.. JAMA. 1897;XXIX(26):1301–1304. doi:10.1001/jama.1897.02440520011001d
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