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 . Fie. 39.— Wounds from powder, dirt and small pieces of stone, which mustbe removed to avoid tattooing. Palsy of lower fibres of facial nerve withoutexternal wound. (Courtesy of Dr. H. IV Scarlett.) skin should be picked out, otherwise the carbon in powder willleave bluish tattoo marks. The distortion due to bony lesionsmust be prevented, as far as po


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 . Fie. 39.— Wounds from powder, dirt and small pieces of stone, which mustbe removed to avoid tattooing. Palsy of lower fibres of facial nerve withoutexternal wound. (Courtesy of Dr. H. IV Scarlett.) skin should be picked out, otherwise the carbon in powder willleave bluish tattoo marks. The distortion due to bony lesionsmust be prevented, as far as possible, by early and accuratereplacement of fragments. A great amount of power may berequired to pry up depressed fragments or alter the relation ofbones driven together by the vulnerating force. WAR WOUNDS OF THE FACE AND THEIR TREATMENT. 71 The side of the face is greatly deformed by depressed fractureof the zygomatic arch. The depressed portion should be ele-vated with a lever, introduced through an incision made parallelto the margin of the zygoma. A similar elevation of bone maybe required when the anterior wall of the sinus of the upper jaw. Fig. 40.— War wound of cheek.[Courtesy of Dr. H. W. Scarlett.) has been crushed in. Hooks like icetongs have been used to liftup the fractured portion. In extensive osseous injuries, the bones should be accuratelyadjusted and held in position, if necessary by chromicized catgutsutures, introduced through drill holes. Sterilized bone or ivorypegs or steel nails and tacks may be employed to nail the bony 72 WAR SURGERY OF THE FACE. structures together, if sutures are not effective. The nails maybe removed later or allowed to become encysted; bone or ivorypegs will be absorbed, if the wound remains aseptic. Teethknocked out should be washed with mild antiseptic solution andreplaced in the socket previously sterilized. The adjoining teethmay be utilized as a sort of splint to which the loose teeth maybe tied or wired. Keeping the mout


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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky