Surgical therapeutics and operative technique . owing thetopography of the loss of substance when this is on a small scale; by approachfrom a distance, according to the Italian method, when it is loss of substance afterwards persisting may be filled with the aid ofdermo-epidermic grafts, according to the method of Reverdin or of may also try complete transplantation of cutaneous flaps, which arethen secured in position by continued suture, made with fine silk, to theedges of the surrounding healthy skin, which have been carefully vivifiedbeforehand. An elastic comp
Surgical therapeutics and operative technique . owing thetopography of the loss of substance when this is on a small scale; by approachfrom a distance, according to the Italian method, when it is loss of substance afterwards persisting may be filled with the aid ofdermo-epidermic grafts, according to the method of Reverdin or of may also try complete transplantation of cutaneous flaps, which arethen secured in position by continued suture, made with fine silk, to theedges of the surrounding healthy skin, which have been carefully vivifiedbeforehand. An elastic compressive dressing can then be applied. 174 SURGICAL THERAPEUTICS AND OPERATIVE TECHNIQUE Tumours. Papillomata. We meet in the cervical region with papillomata, either simple or pig-mented, which are liable to undergo malignant transformation; moreespecially that of degeneration into melanotic sarcoma. These littletumours, when they have become the seat of chronic inflammation, shouldbe destroyed by thermic Fig. 290.—Multiple Lipomata of Nucha, Neck, and Trunk. Subcutaneous Lipomata. Lipomata of the/neck may he of small size. Multiple hpomata are also met with. They develop symmetrically, and may grow to a considerable volume. I have observed in many of these cases six large lipomatous masses, two anterior, situated in the lateral suprahyoid regions; and four posterior, OPERATIONS ON THE NECK 175 the upper pair of which were situated on the nucha, and the lower astridethe cervico-dorsal region. Operation on such hpomata is not a grave pro-cedure. It is easy when the tumours are encapsuled. It may be a dehcateone when they are multiple, as it is very difficult to recognize the dividinghmit of the neoplastic and non-pathological adipose tissue.
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