Cases of deformity of various kinds, successfully treated by plastic operations / by Thomas D. Mütter.

  • Thomas Dent Mutter
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: Cases of deformity of various kinds, successfully treated by plastic operations / by Thomas D. Mütter. Source: Wellcome Collection.

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    this period, had been gradually increased in size, with the view of distending the nostril, as well as to give it a proper “set” and the granulations within, which were very luxuriant, touched twice a day with a weak solution of the nit. argent, or creosote, and occasionally with solid caustic ; at the end of the sixth week from the day of the first operation, it was determined to execute the “ third step” in the treatment. This consisted in the division of the skin and cellular tissue at the base of the flap in a semi-circular direction, the con- vexity of the curve looking outwards. The object of this incision was to give the peculiar rounded margin of an ori¬ ginal ala ; to diminish the fulness of the cheek where the na¬ tural depression should exist, which depression had of neces¬ sity been destroyed by the tension of the flap, and to permit a return to the perpendicular position of the deviated septum nasi. The incision was made with a small scalpel, and ex¬ tended to the depth of three lines. In order to prevent union of its margins, a small roll of oiled lint was introduced into the cut, and a strip of adhesive plaster applied to the tip of the nose, and fastened on the cheek of the sound side. (See PI. Fig. 3, a, for shape of incision.) The patient was ordered to confine himself to his room, and to reduce his diet. On the third day the dressings were removed, and it was found that the margins of the incision were nearly cicatrized and beautifully rounded off. The same dressing was reapplied, and the plug intended for both incision and nostril increased in diameter. No change of importance was made in the dressing, or in the subsequent general treatment, except that the patient was allowed to re¬ turn to a more generous diet, and to take exercise in the open air. At the expiration of the eighth week, the nose presented the appearance exhibited in PL /., Fig. 3. The contraction of the granulations had caused the margin of the flap to be rounded oft’, and the cicatrice resulting from the union of the first and third incisions, which was originally located nearly upon the dorsum nasi, to descend nearly to the cheek. This