Volume 1
A manual of operative surgery / by Frederick Treves.
- Sir Frederick Treves, 1st Baronet
- Date:
- 1891
Licence: Public Domain Mark
Credit: A manual of operative surgery / by Frederick Treves. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
731/795 page 699
![LE£DS AWf STRIDING IH DICO-GHlPURCrCAL SOSI? part v.] EXCISION OF UPPER JAW. 699 (7) Any bleeding from the depths of the cavity should now be checked so far as is possible. It will usually be desirable to plug the cavity with gauze. Iodoform or cyanide gauze may be employed. The amount introduced must be noted, and the ends of the strips so placed that they can be readily reached from the mouth. A silk thread may be attached to the end. of each strip, and brought out of the mouth and fastened to the cheek. The actual cautery may sometimes be' used with good effect to check the haemorrhage. The skin wound is finally united very carefully with silkworm gut sutures, especial care being taken to accurately adjust the red margin of the lip. No harelip pins are necessary in any ordinary case. The wound is finally well dusted with iodoform, and dressed with a firm dry dressing. Comment.—This operation has the following great advan- tages :—The bone is well exposed, and plenty of room is provided for its excision; the vessels and nerves are cut at a distance from their trunks, the salivary duct is not interfered with, and the scar is so placed as to produce but little deformity. The operation, moreover, allows of easy control of the haemorrhage. In the matter of the resulting deformity Mr. Butlin observes ( Operative Surgery of Mabgnant Disease, 1887, page 128) :— When the lower margin of the orbit has been removed, the lower eyelid often swells, becomes red and cedematous, and may remain so in spite of every means taken to rebeve it. The disfigurement produced by this cause is very marked. If the posterior nares be plugged, and if the steps of the operation be followed in the order given, no blood should find its way into the mouth until the last stages of the excision are reached. Farabeuf does not divide the lip until towards the last. His first incision ends at the ala of the nostril. The nasal, orbital, and malar parts of the bone are separated. The cut is finally carried through the lip, and the palate segment of the bone dealt with. In many text-books the removal of the incisor tooth is](https://iiif.wellcomecollection.org/image/b21511330_0001_0731.jp2/full/800%2C/0/default.jpg)
