Ptosis operations / by Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932
Date:
[1908?]
Catalogue details

Licence: In copyright

Credit: Ptosis operations / by Freeland Fergus. Source: Wellcome Collection.

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    with, a thread which is absolutely sterile will not produce any permanent cicatricial contraction. If it does set up an inflammatory reaction so as to cause cicatrisation in the tissues, that to my mind is proof positive that the suture employed has not been absolutely sterile, and therefore is one which ought not under any circumstances to have been introduced into the tissues. Moreover, the ends of threads left projecting on the skin surface, unless very carefully protected, are apt to be channels of septic invasion. For these reasons it is probably not far off the mark to say that stitch operations should never be employed. Those forms of procedure which I have classed together under the heading of ligature operations are in the main good, and I think reliable. The chief objections to them are that to some surgeons they are rather difficult of performance. They leave the lid without much mobility, and the success of the operation depends upon the permanency of the metallic or tendinous suture. Still they are essentially good operations. As regards advancement operations, I am satisfied with that of the occipito-frontalis. Of recent years, however, I have always found it advisable to make a very much larger incision than that described in my first communica¬ tion. When 1 attempt to do this operation now I make an incision right along the eyebrow, and then continue it for an inch and a half or two inches upwards and out¬ wards, and thus I am enabled to reflect the skin very thoroughly and get a large and broad strip of the occipito¬ frontalis muscle. Where trouble has been taken to insure the asepticity of the skin, and when the operation has been performed in an aseptic manner, there is no fear of any well-marked cicatrix disfiguring the patient in after life. I have no experience of attempts at advancement of the levator palpebraB superioris, but it is to be remembered that there are many cases of ptosis in which that muscle does not seem to be developed at all. About the year
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