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 . nded to neutralize minor disfigurements, butit is wise to obviate the greater part of the deformity at the timeof the original wound or operation. Gangrene, malignant disease, operation or injury of the cheeknear the corner of the mouth frequently causes a considerableportion of the entire thickness of the wall of the oral cavity to belost. The patie
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 . nded to neutralize minor disfigurements, butit is wise to obviate the greater part of the deformity at the timeof the original wound or operation. Gangrene, malignant disease, operation or injury of the cheeknear the corner of the mouth frequently causes a considerableportion of the entire thickness of the wall of the oral cavity to belost. The patient will be unable to open his mouth when heal- GUNPOWDER TATTOOING AND LOCAL DISTORTIONS. 297 ing has occurred, unless the gap in the cheek has been filled withtissue from some other locality. The cicatrix occurring evenwhen the wound has not been sutured will irresistibly draw thejaws together, and cause a cicatricial lockjaw. This complica-tion may be less marked when the wound has been allowed togranulate than when sutures have been used to get primaryunion. In the former case, however, there may be a gap left inthe margin of the mouth. In either instance the disfigurementof the face will be most distressing and the function of the jaws. Fig. 133.— Cheek repaired with flap from shoulder. Pedicle was dividedafter flap had united wound. (Keens Surgery.) greatly impaired. Osteectomy of the lower jaw in front of thescar tissue will give mobility to the other side of the mouth, butwill not alleviate the external deformity. Plastic reconstruction of the cheek, called meloplasty, at anearly moment is a proper procedure. Bardenheuer cut a flapfrom the forehead, turned it downward and sutured it in the gapin the cheek, with its skin surface toward the interior of themouth. The pedicle of the flap lay alongside of the nose, andwas divided after the flap became attached in its new position. 298 war surgery of the face. The raw external surface of the flap was covered by a flap ofsimi
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