Plastic surgery; its principles and practice . Fig. 255. Fig. 256. Lanes operation, continued (Binnie).Fig. 255.—Reflect the mucous flap 4, 3, 2, and separate the mucoperiosteal flap fromthe bone through the incision 2, Then divide the attachment of the soft to thehard palate in the usual way. Turn over the flap 7, 5, 6, 8. so that its mucous surfaceis toward the nose and its raw surface toward the mouth. Draw the free edge of the flap7, 5. 6, 9. under the flap 9, i, 2, 3, 4. and suture it into position as 256.—Indicates the position of the flaps after they are sutured. 292
Plastic surgery; its principles and practice . Fig. 255. Fig. 256. Lanes operation, continued (Binnie).Fig. 255.—Reflect the mucous flap 4, 3, 2, and separate the mucoperiosteal flap fromthe bone through the incision 2, Then divide the attachment of the soft to thehard palate in the usual way. Turn over the flap 7, 5, 6, 8. so that its mucous surfaceis toward the nose and its raw surface toward the mouth. Draw the free edge of the flap7, 5. 6, 9. under the flap 9, i, 2, 3, 4. and suture it into position as 256.—Indicates the position of the flaps after they are sutured. 292 PLASTIC SURGERY In this way very large defects may be covered. This method wasmuch used for a time, but is now employed principally as an adjunct tothe edge-to-edge operation. The end results were not what were hopedfor and the danger of slough was found to be greater. If it occurs, thepatient is left in bad condition for subsequent operations. For detailed. Fig. 257. Fig. 258. Lanes operation for wide double incomplete cleft 257.—yiake the flap i, 2, 3, as in a case of single complete cleft palate. On theopposite side make the incision 6 through the mucoperiosteum along the edge of the the incisions 7 and 8 on the nasal side of the soft palate, and reflect the flap ofmucous and submucous tissue. Separate the mucoperiosteal flap from the hardpalate and divide the attachment of the soft to the hard palate, leaving the oral mucosaintact. Fig. 258.—Then insert the flap i, 2, 3 and suture its free edge well under 10, 6, 7, 8. information on this method the reader is referred to Brophys, Blairs,and Lanes works on this subject. Secondary Operations for Cleft Palate Secondary operations are often required in cases operated on forcleft palate, when there has been a complete or partial failure of thesutured flaps. If the failure is complete the operation should be done over again,but the chance for success is less than a
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