A case of extroversion of the bladder treated by preliminary narrowing of the gap existing in the pubic symphysis by means of division of the sacro-iliac synchondroses / by G.H. Makins.

  • Makins, George Henry, 1853-1933.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A case of extroversion of the bladder treated by preliminary narrowing of the gap existing in the pubic symphysis by means of division of the sacro-iliac synchondroses / by G.H. Makins. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The patient was again slung in his cot, and the flaps covered with a warm pine-wood bag, a large drainage- tube being inserted into the bladder from below. The after-progress of this operation may be briefly disposed of; the skin became inflamed on the second day ]?I&- 3_ a Shows outline of exposed bladder at operation of May 4tb, 1887 j b shows large flap turned across and small flap turned down from upper margin ; c shows raw surface. and the whole gave way, some sloughing occurring at the edges. It is doubtful whether the warm pine-wood bags, which had been impregnated by soaking in a mercurial lotion, were not in some measure answerable for this failure. The granulating surface left rapidly healed, and forty-one days later it was decided to raise a skin flap on the right side. A flap, three inches by two, with its base at Pou- part’s ligament and its left edge close to the bladder margin, was lifted. This was allowed to thicken for two months, and on May 4th, 1887, it was turned across and united to the left margin, a small flap three quarters of an inch in width being turned down from above to close the upper limit of the cavity. The upper flap, however, consisted mainly of cicatricial tissue and sloughed, while the large flap, after holding for about ten days, became inflamed, and the wound suppurating, the bond of union completely gave way.