Plastic surgery; its principles and practice . btainedwhen the thickened contracted fascia is approach varies with the extent of the con-tracture. The condition of the skin involve-ment with scar tissue should determine to whatextent it should be utilized in closing the de-fect. Unless there is a reasonable chance ofsuccess it should be excised, and the defect cov-ered with a graft of whole-thickness skin, or with a pedunculated flapof skin and subcutaneous fat, from a distant part. The latter methodeliminates any pain which might occur following the removal of theprotection afford
Plastic surgery; its principles and practice . btainedwhen the thickened contracted fascia is approach varies with the extent of the con-tracture. The condition of the skin involve-ment with scar tissue should determine to whatextent it should be utilized in closing the de-fect. Unless there is a reasonable chance ofsuccess it should be excised, and the defect cov-ered with a graft of whole-thickness skin, or with a pedunculated flapof skin and subcutaneous fat, from a distant part. The latter methodeliminates any pain which might occur following the removal of theprotection afforded the underlying parts by the palmar fascia. FiBROLYSiN has been used in the treatment of Dupuytrens con-traction and good results have been reported, especially after its usein conjunction with multiple transverse incisions through the con-tracted bands. My belief is that the good results were due in largepart to the operation, and the prolonged post-operative massage andsplinting. That the fibrolysin has not much effect is suggested by the. Fig. 802.—^Lotheisensoperation for Dupuytrenscontraction. (Binnie).-—Thecurved incision ABC ismade, the skin is reflected,and the thickened palmarfascia is excised. The fingersare extended and the edgesare closed as far as raw area which is usu-ally left may be grafted. SURGERY OF THE EXTREMITIES 679
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
