. Operative surgery. Fig. 702.—Burows method,flaps united. Fig. 703.—Jaesche-Dieffen-bach method. 9. Fig. 704. —Litten-neurs method. which they correspond. The flaps d a c and c h d are dissected up freelyand united with each other (a c to h c). This union causes great relaxationof tissue at either side (a d e and h e d), which tissue is removed and theborders properly joined with sutures forming the outlines of Fig. 702. Jaesclie-Dieffenhacli Method (Fig. 703).—The figure of this methodexplains fully the manner of its application. If the incision h d (Jaesche)be carried downward and to the ri
. Operative surgery. Fig. 702.—Burows method,flaps united. Fig. 703.—Jaesche-Dieffen-bach method. 9. Fig. 704. —Litten-neurs method. which they correspond. The flaps d a c and c h d are dissected up freelyand united with each other (a c to h c). This union causes great relaxationof tissue at either side (a d e and h e d), which tissue is removed and theborders properly joined with sutures forming the outlines of Fig. 702. Jaesclie-Dieffenhacli Method (Fig. 703).—The figure of this methodexplains fully the manner of its application. If the incision h d (Jaesche)be carried downward and to the right h e, parallel with the border h c (Dief-fenbach), thereby forming flap c h d e, and the flap be dissected up and slidto join ah c, the gap will be readily closed. Littenneurs method of closure of quadrilateral spaces by the curvedsliding process is as follows (Fig. 70-i) : The flap b e f g is raised and slidso that the borders e f and a d are united with each other. Ht^. e/ii Fig. 705.—Briinss method. 11 n [ 1 Fig. 706.—Briinss method, flaps united Briinss method of closure with two lateral flaps is more complex (). In this the flaps a e f g and d h i Jc are raised, carried downward, andcaused to fill the gap a b c d hj uniting the borders h i and e f with eachother (Fig. 706). Elliptical openings of large size can be closed by either of the followingplans of procedure (Figs. 707 and 708). In the former the flaps a c d eand b c d f are raised, displaced upward, and united so as to close the open- 574 OPERATIVE SURaERY, ing. In the latter (Webers method) the flap a c d {?> raised and carriedupward so that the point c can be united with the angle &. The second flapis utilized to close the remaining space (Fig. 708).
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
