Plastic surgery; its principles and practice . Fig. 130.—Scar following complete excision of the internal saphenous vein for varicoseveins.—The scar extends from the saphenous opening to the internal malleolus. The veinis tied on both sides at the opening. The tissues are then turned back as far as necessaryon each side of the incision and all diseased veins are removed. In old cases the skin maybe friable at the site of healed ulcers, and slight separation of the edges may occur, as inthis case. This operation, while it is the most radical, is by far the most Fig. 131.—C. H. Mayos
Plastic surgery; its principles and practice . Fig. 130.—Scar following complete excision of the internal saphenous vein for varicoseveins.—The scar extends from the saphenous opening to the internal malleolus. The veinis tied on both sides at the opening. The tissues are then turned back as far as necessaryon each side of the incision and all diseased veins are removed. In old cases the skin maybe friable at the site of healed ulcers, and slight separation of the edges may occur, as inthis case. This operation, while it is the most radical, is by far the most Fig. 131.—C. H. Mayos vein stripping operation for varicose veins (Binnie).Expose and isolate the internal saphenous vein near the saphenous opening. Divide itbetween ligatures. Pass the peripheral end of the vein through the loop in Mayosdissector (a). Following the vein, push the dissector down to a point near the knee; cutthrough the skin over the loop of the dissector; clamp the vein peripherally, pull it out,ligate, and remove the loose portion. If adhesions around the vein prevent the stripping,pass the closed lung forceps ib) along side of the stripper, and then by opening the bladesthe adhesions may often be separated. In the same manner continue to remove as manyveins as necessary, always working from above downward in order to avoid detachingthrombi and throwing them into the circulation. INTRACTABLE ULCERS AND VARICOSE VEINS 189 3. Complete excision of the internal saphenous system of veins,as typified by the operations of ]\Iadelung and others (Fig. 130). 4. The subcutan
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
