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 . Fig. 228.—Adams ectropion operation. Fig. 229.— Adams ectropion opera-tion, sutures tied. The pin suture isnot used now. neous wounds. Sometimes the adherent portion of lid may bedissected from the eye and be turned by a mattress suture intothe groove between the base of the eyelid and the ball. If it isstitched in this inverted position, it will pre
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 . Fig. 228.—Adams ectropion operation. Fig. 229.— Adams ectropion opera-tion, sutures tied. The pin suture isnot used now. neous wounds. Sometimes the adherent portion of lid may bedissected from the eye and be turned by a mattress suture intothe groove between the base of the eyelid and the ball. If it isstitched in this inverted position, it will present its cutaneoussurface toward the ball, where the latter is left uncovered byconjunctiva or epithelium. The latter area is covered with con-junctival flaps or grafts. Repetition of adhesion is thus madeunlikely. Harlans method for complete symblepharon of the lower lidis worthy of description. After the adhesion to the globe hasbeen completely divided so that the lid and the eyeball have norestriction in mobility, the lid is detached from the orbital marginby a horizontal buttonhole incision through the skin. This cutmakes a bridge of the lid. fastened to the adjacent structures at. Fig. 230.— Strap flap from temple to lift up lower lid. The skin within thedotted line is cut away to make a raw surface and the strap-like flap is thensutured over the raw space. 398 WAR SURGERY OF THE FACE. its ends only. Through this buttonhole a short but wide flap ofskin, cut from the front of the face, is turned up and stitched tothe raw inner surface of the lower lid. This procedure lines theeyelid with skin, which has its epidermis toward the wound lefton the globe of the eye by the antecedent detachment of the lowerlid. The wound of the face is closed more or less completely bysliding skin from the cheek, and the raw surface on the eyeballmay be covered with conjunctival flaps or grafts, or withThiersch skin grafts cut from the thigh or arm. Care must betaken to have a good blood s
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
