Lectures on the operations of surgery : and on diseases and accidents requiring operations . nite in opinion. ToDelpech and Lallemand the credit of being the first to make anattempt at relieving the deformity is usually rendered; althoughFranco, in all probability, is better entitled to it. Several operationshave been devised for the defect in question ; but it must be obviousthat, while certain general rules of action may be laid down, no oneseries of details will answer in every case. Lallemands Method.—The plan usually resorted to in cases ofpartial destruction of the cheek, unless the open
Lectures on the operations of surgery : and on diseases and accidents requiring operations . nite in opinion. ToDelpech and Lallemand the credit of being the first to make anattempt at relieving the deformity is usually rendered; althoughFranco, in all probability, is better entitled to it. Several operationshave been devised for the defect in question ; but it must be obviousthat, while certain general rules of action may be laid down, no oneseries of details will answer in every case. Lallemands Method.—The plan usually resorted to in cases ofpartial destruction of the cheek, unless the opening is very small,is that proposed by Lallemand. In this operation, after having firstfreshened the edges of the wound, a flap is taken from the adjacentintegument of the neck, turned upon its entire pedicle, by whichmeans torsion is obviated, and then attached by the twisted sutureto the margins of the wound it is intended to occupy. The accom-panying figures, taken from one of ray cases, illustrate the steps ofthis operation better than language can describe them. Fig. 102. Fig. In Lallemands case there was much difficulty experienced, fromthe restive disposition of the child, but the operation eventuated 248 ULCERS OF THE CHEEK. successfully. From the fact that in this method the base of theflap is subjected to but very slight torsion,—the great obstacle tosuccess in most cases of plastic surgery,—it has found many advo-cates, and is to be preferred, in my opinion, whenever practicable,to any other. Bupuytrens Method.—Dupuytren, in cases similar to the above,was in the habit of taking his flap from the most convenient parts,but often twisted it upon its base, as is done in some forms of theRhinoplasty operation ; and, according to his statement, with themost perfect success. There is more danger of sloughing, of course,when the flap is subjected to torsion, and although the method hasbeen followed by successful results, yet it should never be employedwhen the o
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