Plastic surgery; its principles and practice . 2 and 3. Photographs taken whenthe patient was seventeen years old. and after pulsation had ceased. Note the extent ofthe growth and the horrible deformity. Spontaneous hemorrhages were frequent and onseveral occasions almost exsanguinated the patient before the bleeding could be blood channels were found on operation and some were as large as a lead pencil andled directly through into the skull. Radium was used without benefit. There was suchmarked hemorrhage during any operation on the growth that an attempt was made to formscar tis
Plastic surgery; its principles and practice . 2 and 3. Photographs taken whenthe patient was seventeen years old. and after pulsation had ceased. Note the extent ofthe growth and the horrible deformity. Spontaneous hemorrhages were frequent and onseveral occasions almost exsanguinated the patient before the bleeding could be blood channels were found on operation and some were as large as a lead pencil andled directly through into the skull. Radium was used without benefit. There was suchmarked hemorrhage during any operation on the growth that an attempt was made to formscar tissue through the growth in order to make operative procedure possible. This wasaccomplished by the injection of equal parts of formalin, glycerin and 90 per cent, alcohol,as advised by Morestin, and by the injection of boiling water. Multiple punctures withthe Pacquelin cautery were also tried. Finally sufficient scar tissue was produced to allowoperative interference without excessive hemorrhage. Then gradual partial excision Fig. 447.—Hemangioma of the nose, continued.—Shows the result of excisions to spontaneous hemorrhages have ceased and the condition is considerably more will be done for this patient, and eventually we may hope for a nose which willnot be especially conspicuous. 436 PLASTIC SURGERY surrounding skin, the age and condition of the patient, and the im-portance of minimizing the scars made upon the face. It must be emphasized that, in cases in which the framework of thenose has been destroyed, it is useless to attempt reconstruction witheither single or double (external and internal) skin flaps, unless theseflaps are supported by a framework. In all flap operations it is essential to calculate the size and shapeof the flap to be used by means of a pattern made of some materialwhich is flexible and can be sterilized. For this purpose thickrubber-dam is most suitable. The flap should be at least one-thirdlarger than the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
