Plastic surgery; its principles and practice . dicle is cut and sutured into the line LK. Ten days later amputate the flap from the arm and fit it into the un-covered portion of the defect. Care should be taken to make a naturalfold at the root of the auricle. The defect on the forearm may beclosed with sutures, or at least lessened in size; the remaining defectshould be grafted. The adhesion between the auricle and the mastoid region can berelieved by a pedunculated flap turned up from the neck. This isan excellent method. I have used whole-thickness grafts and Ollier-Thiersch grafts with fai
Plastic surgery; its principles and practice . dicle is cut and sutured into the line LK. Ten days later amputate the flap from the arm and fit it into the un-covered portion of the defect. Care should be taken to make a naturalfold at the root of the auricle. The defect on the forearm may beclosed with sutures, or at least lessened in size; the remaining defectshould be grafted. The adhesion between the auricle and the mastoid region can berelieved by a pedunculated flap turned up from the neck. This isan excellent method. I have used whole-thickness grafts and Ollier-Thiersch grafts with fair success, but the pedunculated flaps give thebest results. Perforations of the Auricle Small perforations of the auricle can be closed by properly shapedflaps of skin from the ear itself. If the perforation is of considerable 4i6 PLASTIC SURGERY size, it should be closed by means of a pedunculated flap from thescalp or neck, turned on itself, as previously described in other opera-tions. The Italian method may also be used in selected 123 4 Fig. 421.—Partial reconstruction of the ear for a defect following trauma.—Durationseveral months, i. The extent of the defect is well shown. Note that the remainingportion of the ear stands well away from the head. 2, 3 and 4. The reconstructed portionthree months later. Several shaping operations will be necessary to complete the flap to reconstruct the ear was obtained from the hairless portion of the skin behindand below the ear. The uninjured ear was also very prominent and the cartilage removedfrom this ear was utilized in preparing the framework, and the skin also was employed forfilling defects. Retro-auricular Fistulae and Depressions Some of these fistulae are the result of radical mastoid operationswith long-continued drainage. They are lined with epithelium and are
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