Biological- or artery flaps of the face / by J.F.S. Esser.

  • Jan F. Esser
Date:
[1928]
Catalogue details

Licence: Public Domain Mark

Credit: Biological- or artery flaps of the face / by J.F.S. Esser. Source: Wellcome Collection.

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    plate. To this situation we brought a temporal flap and the following plates show the results. In this case only sufficient material was requi¬ red to cover the chin and we were able, after a few weeks, to return to the place it was taken from, all the superfluous tissue of the flap between the limits of the chin and the pedicle. In similar cases later on we made the pedicle rather longer and the flap arises from it more gradually so that there was practically no superfluous tissue in the flap or pedicle, and nothing to be returned; this has the advantage that the flap is per¬ manently supplied with its own vessels and nerves. Plates 6 D 39-40. Patient D. See page 33. Patient D was a very severe case of necrosis caused by X-rays. Speaking of X-rays in general, it may be said that they gave origin to the most difficult plastic work, and also to injuries most difficult to heal, before the Biological- or Artery Flap method existed. The Biological- or Artery Flap, brought from far away, from parts which had not suffered by the X-rays, is the only method without com¬ petition able to help in such cases, for two reasons. First, this flap is sure of its own existence by bringing its own nourishment and its own waste-pipes to expel products of life. Secondly, its cleaning service and its nourishment is so sure and powerful that it is not only sufficient to assure its own life, but it first helps by its contact alone to purify the surface of the weak wound, which is covered by milliards of dead tissue particles, that are poisoning by their toxins the surrounding still living particles, which fight despairingly, almost without circulation or inner¬ vation. We introduced this principle and published it see nr 47, p. 172 in 1919. By and by the flap takes a slight contact here and there and begins to grow together with cleaned parts of the wound, while its cleaning, nourishing and innervating power is giving new life to the almost dead wound surface. More and more the two grow together, always leaving room for pus to escape, because, in such cases, the flap is fixed with only a few metal sutures here and there to keep it in the right place. The result, see plate 6D, was obtained after several weeks, but it was complete and satisfactory.
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