The practice of surgery . ially to come out from the anesthetic and to cry from time to air-passages are thus cleared and the surgeon feels child, tighth- swathed in a sheet, should be held upright in the armsof an attendant, behind whose shoulder stands the etherizer with hiscone, while the surgeon sits in front of the patient. The tj^es of hare-lip operations are many, but the good operations are all much of akind. In a word, a good harelip operation involves loosening with 1 J. G. Mumford, Medical and Surgical Treatment of Harelip, Boston Med. andSurg. Jour., March 3,
The practice of surgery . ially to come out from the anesthetic and to cry from time to air-passages are thus cleared and the surgeon feels child, tighth- swathed in a sheet, should be held upright in the armsof an attendant, behind whose shoulder stands the etherizer with hiscone, while the surgeon sits in front of the patient. The tj^es of hare-lip operations are many, but the good operations are all much of akind. In a word, a good harelip operation involves loosening with 1 J. G. Mumford, Medical and Surgical Treatment of Harelip, Boston Med. andSurg. Jour., March 3, 1S98. 536 THE FACE AXD NECK blunt-pointed scissors the cheek from the upper jaw, so as to dimin-ish subsequent traction, carefully trimming and adjusting with theknife the wound-edges to be sewed and everting downward a mar-ginal flap so as to obviate the puckered notch which comes withthe contracting scar of a badly done operation. There is a familiarand abominable operation, which consists in slashing with scissors the. Fig. 348.—Infant hold in position for harelip operation. edges of the cleft, so as to transform it into a raw inverted V, andsewing it up with through-and-through stitches. Invariably thereresults an ugly notched lip. The text-books tell of the operations ofNelaton, Malgaigne, Mirault, von Langenbeck, Simon, and a dozenothers. Nelatons operation is applied to single notches. The requiredcuts are made through the lip above the notch with no sacrifice of tissue. HARELIP 537 When the ends of the cuts are brought together the notch is convertedinto a nipple, the principle of the operation being similar to that of theHeineke-Mikulicz pyloroplasty. If the cleft in the lip be single andreach nearly to the nostril, it is necessary to sacrifice some tissue. Butnames and descriptions count for little; the accompanying diagramsshow best how these operations may be done. Double harelip is far more difficult to close successfully and properlythan is the single harelip.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
