War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . ig. 249.— Snydackers blepharoplasty with flap from neck. to prevent ectropion after removal of tumors, or to completeother operative procedures. The thin hairless skin of the innerpart of the thigh or arm or of the region back of the ear may beused. The area from which the flap is to be cut must be steril-ized thoroughly and then bathed in sterile ph
War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . ig. 249.— Snydackers blepharoplasty with flap from neck. to prevent ectropion after removal of tumors, or to completeother operative procedures. The thin hairless skin of the innerpart of the thigh or arm or of the region back of the ear may beused. The area from which the flap is to be cut must be steril-ized thoroughly and then bathed in sterile physiological saltsolution. The region to which it is to be transplanted must besterilized and similarly bathed. If it is a raw surface, bleedingshould be checked; if an ulcerated surface, the granulations 4io WAK SURGERY OF THE FACE. should be free from unhealthy complications and be thoroughly-sterilized. The flap should consist of the whole thickness of the skin andhave all the fat on its under surface entirely clipped away withsharp scissors. Its area should be about one-third greater thanthe space to be rilled. When stitched in place it may appear toothick for the purpose. This will usually be corrected by thechanges occurrins: Fig. 250.— Temporal flap to fill space under eye to avert cicatricial ectro-pion after excision of epithelioma. (Authors case.) A dry sterile gauze dressing should be applied with moderatepressure and left undisturbed for three or four days. When anew dressing is to be applied, the old one should be loosened bysaturating it with sterile salt solution. The flap and the adja-cent skin should be dried with sterile cotton and a new dry gauzedressing applied and left in place several days. Too frequentdressing is liable to be detrimental by displacing the flap or dis-turbing the adhering edges. No antiseptics should be usedupon it. Frequently the epithelium and the underlying cells of the flapwill break down or be so modified by what appears to
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