On the operative treatment of harelip / by W. I. Wheeler.

  • Wheeler, W. I. (William Ireland), 1846-
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: On the operative treatment of harelip / by W. I. Wheeler. Source: Wellcome Collection.

    22/80 page 12
    hours after, I removed the needles, and placed fresh strips of plaster over tlie ligatures, which remained, as is their w^ont, and fell off usually at the second dressing. Three weeks after the operation there was scarcely a mark perceptible ; a mere line delineated where the joining took place ; the nasal ala on the right side raised and corresponded with the left; the gums joined and filled in the open between the bones. The altered appearance of the child, as represented in Plate 3, denotes faithfully the improvement. The boy left hospital on the 24th of July, 1874. Case IV.—Richard R., aged six months, was admitted under my care on the 9th October, 1876, recommended by my friend, Mr. Patten, now resident surgeon of the hospital. He was born of hejilthy parents, whose previous children were not aflSicted with any deformity. This was a handsome boy, with large bril- liant eyes, high forehead, and a-most animated countenance. He suffered from a division of the upper lip to about half its extent towards the right side, with depression of the right nasal ala. The maxillary bones were completely united, and the gum was perfectly even. On Saturday, the 14th October, I proceeded to operate after this manner, the child having been rolled in a sheet, and placed on the lap of an attendant, an assistant steadying the head r— In order to allow the nose to elevate, I first passed up a narrow-bladed knife beneath the lip towards the right sidcj and separated from their osseous attachments the parts holding depressed the right ala, and carried my knife up and across to the left side, even to the septum narium. By this means I effected my object in getting the nose to rise. I now made a semicircular incision above the separation in the lip, which left a diamond- shaped space, and pulled down this cut portion to form the prolabium (or red margin), and then brought the surfaces of the gap left above into apposi- tion by means of two fine needles, round which a silken ligature was carried as in the figure of 8 or twisted suture, taking care that the lower pin lightly traversed the superior edge of the portion of the fissure pulled down. It is necessary to observe this latter point, or undue protrusion of the marginal portion of the lip will occur at the part where the fissure has been lowered. Two narrow strips of plaster were fitted between the needles and brushed over with collodion ; a third held a small pad of lint placed at the right side of the nose. This corrected its depression, before noticed.
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