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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    PREFACE. I introduced my method of « Biological- or Artery Flaps » in 1913, after my methods the «Epithelial inlay» and the «Rotation of the Cheek ». It would have been more correct to call it only « Biological Flaps )), but 1 added the name « Artery Flaps » to facilitate the establishing of the place and form of the Flaps, as the veins, lymph vessels and nerves run together with the Artery. The principle of the « Biological Flaps » or « Artery Flaps » is, that the pedicles are thin, generally short and consist only in veins, arte¬ ries, lymphvessels and nerves, surrounded with a small covering or protecting sheet of elastic connective tissue, but have no skin or other tissue. The tissues would bring no advantage, but they could easily close the vessels by pressure, if the pedicles are very much turned. I introduced the <( Biological- or Artery Flaps » in various articles and lectures in Medical societies of Berlin and later in 1922 in the Sur¬ gical Congress at Berlin. Formerly the surgeons used the everywhere recommended rule to cut the pedicles at least as broad as one third of the length of the flap. Dieffenbach went so far as to recommend to cut any artery, if found in the pedicle. This was not right, but his great authority caused, that every one followed and propagated his advice. Surely he must have seen, that flaps often died by overabundance of blood filling. The colour of the flaps grew from red to black, till they died. He did not observe, that the absence of veins and lymphvessels caused the death, of the flap and not the presence of arteries. Another mistake was made in a small publication of one operation by Monks, found by one of my assistants some years ago. He was said to have propagated the use of an abnormally long, all over very thin pedi¬ cle, which had to contain the artery Temporalis. The disadvantage was especially dangerous for unexperienced sur¬ geons, because even if, by chance, besides the Artery, the nerves, veins and lymphvessels were conserved in the pedicle, this inclines to fail : a) by the difficulty of its technic ; b) by the risk of missing interesting elements ;
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