Plastic surgery; its principles and practice . ?J5Sg^iS ^^^ Fig. operation for elephantiasis, 862.—Shows the method of undercutting used to remove a wide area of subcuta-neous fat. Fig. 863.—Cross section of Fig. 862. The dotted lines indicate the incisions made inremoving the fat. SURGERY OF THE LOWER EXTREMITY 717 cuts. The mass of skin, fat and deep aponeurosis is then removed,leaving the muscles exposed. (If it is on the inside of the lowerextremity the internal saphenous vein is tied off.) All bleeding ischecked, and the wound is closed without
Plastic surgery; its principles and practice . ?J5Sg^iS ^^^ Fig. operation for elephantiasis, 862.—Shows the method of undercutting used to remove a wide area of subcuta-neous fat. Fig. 863.—Cross section of Fig. 862. The dotted lines indicate the incisions made inremoving the fat. SURGERY OF THE LOWER EXTREMITY 717 cuts. The mass of skin, fat and deep aponeurosis is then removed,leaving the muscles exposed. (If it is on the inside of the lowerextremity the internal saphenous vein is tied off.) All bleeding ischecked, and the wound is closed without drainage, so that the skinwith a small amount of subcutaneous fat comes in contact with theexposed muscles. If the condition of the patient permits, the otherside of the extremity is similarly treated immediately. If the conditiondoes not warrant further work, the second operation is postponed until. Fig. 864.—Elephantiasis of the right leg in a negress.—The etiology is obscure. Thepatient has had a leg ulcer off and on, but there is no history of erysipelas. No filaria couldbe found. The thigh was only slightly enlarged and its tissues were soft and apparentlynormal. a suitable time. The patient is allowed to get up ten days after theoperation, the part being supported with an elastic bandage. The results in my own experience with Kondoleons operationhave been only fair. Possibly my excisions have not been quite soradical as those in the operation just described, and this may explainwhy I have not secured the hoped for results. In one of my cases, agirl of 22 years first noticed a swelling of the right leg and thigh whenshe was 17 years old. The etiology was absolutely obscure; nothingcould be found in the history or by physical examination to accountfor the condition. During the operation on this case I had greatdifficulty in checking the lymph flow. The thigh wound would fi
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
