Plastic surgery; its principles and practice . ^or ulceration) with skin. ^Davis, J. S., Johns Hopkins Hospital October, igii, 372. 620 PLASTIC SURGERY With the exception of a few words on the treatment of herniaof the lung through the thoracic wall, the surgery of the trunk will bedealt with here only so far as it concerns the repair of surface defectsand contractures. Usually extensive contractions of the neck and axilla are closelyassociated with those of the trunk. Many small defects may be closedby the plastic methods previously described. I have seen extensivecontracted scars invo
Plastic surgery; its principles and practice . ^or ulceration) with skin. ^Davis, J. S., Johns Hopkins Hospital October, igii, 372. 620 PLASTIC SURGERY With the exception of a few words on the treatment of herniaof the lung through the thoracic wall, the surgery of the trunk will bedealt with here only so far as it concerns the repair of surface defectsand contractures. Usually extensive contractions of the neck and axilla are closelyassociated with those of the trunk. Many small defects may be closedby the plastic methods previously described. I have seen extensivecontracted scars involving the entire front or side of the chest and. Fig. 718.—Method of reducing the size of a granulating wound by elastic traction.—The wound pictured was due to the excision of the breast for a severe infection. Notethe muslin bands, to which the hooks are sewed, pasted to the skin. Ordinary smallelastic bands are placed over these hooks and they exert continuous elastic traction on theskin edges. In this way the size of the wound may be considerably reduced in a compara-tively short time. abdomen, and the upper portion of the thigh. To avoid permanentasymmetry it is essential to break the continuity of such scars in severalplaces in order to straighten the body (complete excision being out ofthe question). This should be done as early as possible and can beaccomplished by means of skin grafts alone (preferably of whole-thickness), or with pedunculated flaps shifted in from any availablenormal skin. Sometimes a combination of these methods is advanta-geous. The skin of the trunk is a very useful source of supply in obtain- SURGE
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