Plastic surgery; its principles and practice . lower portion of the outer the size and shape of the grafted defect, it should usuallyextend to the top of the axillary fornix. Thus the thoracic or innerwall of the apex of the axilla is always lined with skin grafts. Skin grafts seem to offer a definite obstacle to the growth ofmetastases, and it is very rare, if ever, that the grafted area is invaded. SURGERY OF THE NECK, TRUNK, AND EXTREMITIES 625 If metastases occur in the (leejKr tissues beneath the graft, they can beseen and attended to. The operation of shifting the other bre
Plastic surgery; its principles and practice . lower portion of the outer the size and shape of the grafted defect, it should usuallyextend to the top of the axillary fornix. Thus the thoracic or innerwall of the apex of the axilla is always lined with skin grafts. Skin grafts seem to offer a definite obstacle to the growth ofmetastases, and it is very rare, if ever, that the grafted area is invaded. SURGERY OF THE NECK, TRUNK, AND EXTREMITIES 625 If metastases occur in the (leejKr tissues beneath the graft, they can beseen and attended to. The operation of shifting the other breast over to cover the defectit)llowing breast amputation is not only unnecessarily extensive, butalso prevents the early recognition of any metastases, because of itsthickness. Methods of Closing Defects on the Trunk.—Many methods havebeen devised for closing the defect after amputation of the breast,and the principles involved in the majority of these may be applied infilling defects anywhere on the trunk. My belief is that plastic opera-. FiG. 725.—Method of closing a chest defect by means of a flap including the other breast{Weichert).—i. The defect is indicated by the shaded area. The dark line indicates theincision marking out the flap A. 2. The flap A in position and all wounds closed. tions are not desirable in covering defects left by the radical opera-tion for carcinoma of the breast, such as shifting over the other breast,but that they may be used with great advantage in covering defectsfrom other causes. Unfortunately, all of these flap operations onthe trunk are based on the utilization of skin which is not infiltratedwith scar, and a glance at the diagrams will show the impossibilityof carrying out successfully these methods unless the skin is this reason in many instances we must depend on skin large defects the Ollier-Thiersch variety is that usually employedon the trunk, but when the defect is smaller, whole-thickness graftsgive good r
Size: 2130px × 1173px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
