Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren.

  • Jonathan Mason Warren
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    10/40
    tion was proceeded farther in, attention was given to diminishing the large wound made in the scalp. Little hemorrhage had taken place, and the temporal arteries which had been cut, very soon retracted and ceased bleeding. The angles of the wound were first brought together by the twisted suture, two pins being employed on either side. Its edges between the eyebrows were also approximated in a similar manner ; by this means the wound in the forehead was di- minished at once to less than half its original size; it was still farther reduced by the use of a few strips of adhesive plaister, and a little scraped lint filled up the remainder of the wound. Some lint spread with cerate was spread over the whole surface, a pledget, and the whole secured by a bandage round the head. The next object was to fix the borrowed skin in its place. In or- der to do this, it was necessary to freshen the borders around the opening of the nasal fossa, the traces of which, as stated above, had been previously made with nitrate of silver. For this purpose a short narrow knife, somewhat similar to a cataract knife, was used, and a strip of integument a third of an inch in breadth, removed, including all that portion which had been at all indurated during the cicatriza- tion of the ulcerations. The knife was also passed between the lip and upper jaw, in which existed, as before stated, an opening large enough to pass a probe, and the adhesions between the two, for the space of an inch, entirely cut away. This was done for the double purpose of giving the columna of the nose a more deep and firm adhesion, and, in the inflammation which would subsequently ensue, to close up the unnatural communication between the mouth and nasal cavity. The flap was now brought down into its place, its angles a little rounded with the scissors, the better to simulate the alae of the nose, and the whole secured in its place by pins and points of the inter- rupted suture. From that portion of the skin which was to form the columna of the nose, the epidermic side was pared a little, so that it might form an adhesion not only underneath to the jaw, but on its sides to the quadrangular wound made for it in the upper lip. A little scraped lint was now placed under the ends of the pins, and a strip of oiled hnt introduced into each nostril to prevent adhe- sion ; another strip was placed upon the nose to preserve its tem- perature. The dressings were secured by a band of adhesive plaister fixed to the forehead above, and partially divided in the middle so that it might descend on each side of the nose to the lip.