626 Diseases of the Genital Organs 



the latter tissue. With No. 2 or 3 chromatized catgut, the 

 endocervical and vaginal mucosa are brought together with 

 interrupted sutures. 



Trachelorrhaphy 



The treatment of lacerations of the cervix, although in 

 general it has received little consideration, is a subject 

 having no little importance. At the time of parturition, 

 most cows receive at least minor lacerations or epithelial 

 abrasions, and a certain percentage of these, dependent upon 

 the degree of infection present, ultimately develop an endo- 

 cervical inflammation (See Fig. 199). 



Repair of epithelial lacerations should be secured within 

 a short time after parturition, before inflammatory pro- 

 cesses have arisen or healing occurred by cicatrix. Such 

 repairs are almost wholly limited to the region of the first 

 cervical fold and the parts posterior to it. 



In order to remedy such injuries the cervix is retracted 

 into the vaginal introitus, using strong vulsellum or tenacu- 

 lum forceps, placed in such a manner as to prevent any en- 

 docervical injury. The cervix may further be brought into 

 view by the use of one or more cervico-vaginal speculums, 

 which serve to push aside the vulvar lips. The cervical lips 

 are now spread apart, exposing the laceration ; if the lips 

 are much constricted, forming a very small os, the first fold 

 may be retracted gently with a pair of small tenaculum for- 

 ceps and everted slightly to expose the laceration sufficiently 

 for repair. Using a No. 4 half-circle Mayo catgut needle, 

 or similar pattern, with No. or No. 1 catgut, the lacera- 

 tion is closed with either an interrupted or a continuous 

 suture, but the former will secure a better coaptation in 

 most cases. The needle is usually best passed through both 

 margins of the wound at once, from the side which is most 

 accessible, turned upon its long axis, and the point brought 

 sufficiently into view that it may be grasped by the needle 

 holders. Great care must be taken not to tear the mucosa, 

 since the replacement of the sutures becomes extremely 

 difficult. For this reason, the Mayo cervix needle is prefer- 

 able to others, as it punches rather than cuts a hole. All 



