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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    has occurred, which may not be until after a week or two, the slip is again raised by incision, and cut off close to the adherent flap. The wound in the ridge of the nose is then united by suture.”—Practical Sur¬ gery^. 233. London: 1837. It is evident that in all these plans, a wound of greater or less extent must be made in the cheek or forehead, the cica¬ trice of which gives rise to considerable deformity. But in addition to the inevitable occurrence of deformity, another objection of much moment presents itself against the first and last. Every one familiar with operations is aware, that when a part is twisted, or caused to deviate from its natural direc¬ tion, to such an extent as to occasion an impediment to a free circulation of blood through it, gangrene is very often, though not invariably, the result. Hence the great difficulty in the rhinoplastic operations, where a flap is taken from the forehead or cheek, and torsion resorted to. In the operation I have performed, both of these difficulties are done away with. There is no scar on the face, or at most one scarcely perceptible, and no torsion of the flap being re¬ quired, union by the first intention is almost “ a thing of certainty.” The free supply of blood to the flap is also another circumstance in its favour. Such is the laxity of the cellular tissue of the cheek, that no difficulty whatever is experienced in the approximation of the parts. The only objection to this operation is, that unless the incisions are carried oativards sufficiently far, the sub¬ sequent contraction of the flap may cause a deviation of the septum nasi; but this can scarcely be termed an objection, inasmuch as it is always subject to remedy. It is, I am aware, unsafe, if not unwise, to attempt the establishment of an operation as a “ standard ” upon the successful termination of a single trial; but so clear is the principle, so simple each step, and so satisfactory the ter¬ mination of the one in whose favour I am enlisted, that I think I may with perfect security recommend it to the favour¬ able notice of the profession.