862 Veterinary Obstetrics 



are to be carefully wiped drj' with sterile gauze. If the opera- 

 tion is upon a fresh case, any necrotic or maimed tissue fragments 

 are to be carefully excised with scissors. If the case is an old one 

 and the wound margins are covered with epithelium, this must 

 be carefully and completely removed. 



The recto-vaginal cloaca is to be widely dilated by means of 

 retractors, and the recto-vaginal walls upon either side of the 

 wound grasped with double tenaculum forceps and drawn back- 

 wards as far as possible, bringing them essentially external to the 

 vulvar lips. 



The sutures may be applied by any reliable method. A good 

 plan is to take heavy braided silk sutures about two feet in length, 

 armed at either end with a full-curved needle. Carry one of the 

 needles into the rectum and, if the operator is right handed, 

 insert the needle into the right side of the recto-vaginal parti- 

 tion about }{, inch from the anterior end of the wound and an 

 equal distance from its lateral margin. Pass the needle down 

 to but not through the vaginal muco.sa, carry it across, insert it 

 in the opposite margin of the wound between the vaginal mucosa 

 and mu.scular tissue, carry it up through into the rectum at 

 a point opposite the entrance on the left side, and remove the 

 needle. Insert the other needle in the same manner about % 

 inch posterior to the first, and pass through the tissues and back 

 into the rectum in the same way. Tie the extreme ends of the 

 suture together, and have an assistant hold it upward out of the 

 way. 



Apply a second suture in the same manner, and repeat until the 

 posterior or external end of the wound is reached. Drop all the 

 sutures along the floor of the rectum, or have an assistant hold 

 them aside. Divide the first suture by clipping away the knot, 

 and then close the engaged portion of the wound by drawing the 

 sutures gently and tying. Do not draw the sutures too tightly, lest 

 they cause necrosis, infection, swelling and tearing out. Repeat 

 the process with each succeeding suture. 



After the sutures have all been tied, and the ends clipped 

 away, begin at the anterior end of the wound, and apply a con- 

 tinuous suture close to the margins to secure accurate apposition. 

 The wound margins on the vaginal side should be closed by 

 accurate continuous sutures in the .same manner as the second 

 suture in the rectum. 



