Contribution to the plastic surgery of the face / by William Anderson.

  • William Edwin Anderson
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Contribution to the plastic surgery of the face / by William Anderson. 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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    rep^irative measures in Europe, an enfeebled constitution and much damage to adjacent tissues necessitate special precau- tion, and there is indeed little doubt that the flap with its cicatricial pedicle would have perished had its separation been completed at one sitting; moreover, under any cir- ■cumstances the more complete vascularisation of the flap secured by the interrupted method of detachment favours rapidity and strength of union in its new position, as well as increased safety from gangrene. 3. The grafting of the raw surface of the flap and forehead. The application of epi- dermic grafts to the under aspect of the flap has many advantages. The conversion of a granulating into an ■epithelial surface obviates the tedious process of cica- trisation within the cavity of the newly-made nose, and at the same time it removes danger of infec- tion, lessens the amount of contraction, and enables the patient to bear any internal support that may be devised. The plan might be employed with equal advantage in certain -other plastic operations, such as that for extroversion of the bladder. The grafting of the frontal surface left by the ■detachment of the flap is of service, not only in fastening the healing process, but also in limiting the cicatricial con- traction, which might otherwise produce disfigurement about the eyebrow and upper eyelid. In this patient there is a slieht elevation of the left eyebrow and a retraction of the inner side of the lid, but the defect is scarcely enough to attract attention. 4. The preparation of a new n^al bone from the nasal processes of the superior maxilla. The plan adopted was on the principle of that of Langenbeck, but the bone available for the purpose was so scanty and friable that the flaps were incapable of maintaining themselves in their new position. Their fixation and sub- seauent consolidation were made possible by the artificial bridge and it may be easily demonstrated by examination that this solidification has taken place satisfactorily. 5. The construction of an artificial bridge. One of the weak Doints in rhinoplasty when performed for ca^es where there has been great destruction of bone is that the new nose un- sustained by any firm tissues collapses and contracts and is liable to impede nasal respiration. Hitherto foreign sub- stances introduced into the new nose for purposes of support have bee“ ill ^ material like silver if fixed to the sides of the gap and moulded into suitable shape will maintain its position and, providiog it is not brought into contact with a granulating surface, will cause no irritation. In fact, neither of the two
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