(1) cut the abdominal wall: The performer position is confirmed, surgeons routinely cleaning, shaving, disinfection, anesthesia, first of all to make a curved incision, followed by incision of the skin layer muscle, external oblique, intra-abdominal oblique, transverse abdominal muscle and fascia, blood vessels should avoid or do in case of a double ligation. Then cut the peritoneum, abdominal abdominal cutting tweezers pick up the cut to be a small mouth, and then patients will reach into his left middle finger or index finger break, under the guidance of the left hand cut in the peritoneum to the appropriate length of exposure to the rumen. (2) out of the uterus: peritoneal incision, the surgeon should re-arm disinfection and flushing with saline and then inserted into abdominal examination the uterus, the fetus and the surrounding organs, to identify whether the rupture and adhesions. Then assistant to the rumen to a forward shift, exposing the uterus. To cut out the outside of the pessary. Pulling the uterus moves to slow, according to a certain angle. Excessive force is easy to tear the uterus. Pulled out the uterus and the uterine incision should be blocked between the edge of large multi-sterile gauze to prevent fluid within the uterus into the abdominal cavity causing infection. (3) uterine incision: After determining the greater curvature of the uterine horns, uterine Fu away, across the board through the uterine wall. The uterine wall incision after ligation of the bleeding was sufficient, carefully cut near the separation membranes. Such as membrane tube water filling, then cut a small hole first release of water births. Put the water to select the appropriate tire location and direction. After the release of water to be part of the tire, and cut with scissors to extend on both sides of fetal membranes to the uterine incision margin flip side, fixed, so that the cutting edge of everted membranes to form a bio-Chong cloth, tires will not drain water outflows into the abdominal cavity, causing pollution. (4) Pull the fetus: fetal take to seize the fetus when the uterine incision along the hind tarsal or forelimb wrist by the Ministry of the direction and angle best suited to slowly pull out the fetus. Such as the incision is too small incision can be extended. Pull out the fetus, the assistant should not let it fixed retracted abdominal hysterectomy. Is produced by the fetus out of the nursing calf. (5) stripping afterbirth: principles of management is to peel all the peel should not be stripped off when the part will have been cut off, let the rest stay in the womb, to be discharged off on its own, but the incision near the edge of the fetal membranes on both sides must Peel cut off, or they impaired suture. (6), uterine suture: the suture before the uterus, the uterus should be evenly spreading powder to it. Uterine suture closure is usually carried out twice, the first full-thickness continuous suture, the second suture embedded serosal muscularis suture. To speed recovery, and uterine bleeding, and is conducive to lochia discharge, in the uterine cavity before closure of vasopressin into the 5 to 10 units. (7) abdominal wall suture: suture the abdominal wall should be carefully cleaned before the abdominal cavity. Abdominal incision after finishing the first peritoneal suture, usually continuous catgut suture, peritoneal seam finished, you should through the incision into the peritoneal oil antibiotics to prevent infection and adhesion. Then layer by layer, continuous suture muscle. Finally nodules suture the skin, slit the skin to the wound edge inversion, otherwise it will affect wound healing, the treatment extended.
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