Gynoplastic Technology, With a Chapter On "sacral Anesthesia"
Gynoplastic Technology, With a Chapter On "sacral Anesthesia"
Sturmdorf, Arnold, 1861-
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Fig. 12. — Incorrect denudation, leading into wrong cleavage lines, and necessitating additional incisions into the levator fascia to expose the muscle. Digitized by Google LEVATOR MYORRHAPHY. 147 overlapping in ventral hernia, while the pelvic floor fascia does not. The torn levator fascia, limited in extent by its firm attachment to the pubic arch, attenuated by re- traction, and partly obliterated by cicatricial fusion, does not oflfer the reconstructive essentials to per- manent support. Th...is is substantiated by the short- comings in the functional results of the classic fascial perineorrhaphies. Efficient overlapping is impossible. ''A chain is as strong as its weakest link." Fascial suture can- not reproduce fascia, but only an edge-to-edge cica- tricial junction at best. An unbiased criticism of the results following the classic fascial methods of perineorrhaphy in vogue will concede a more or less perfect cosmetic restora- tion of perineal contours and bulk, in which, how- ever, the all-essential physiologic muscular element in pelvic support is supplanted and immobilized by a vicarious cicatricial plug at the vaginal outlet.
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