. Surgery, its principles and practice . by introducing the pipetcautiously a second or even a third time, exhausting the air. When thegraft thoroughly lines the cavity, it is held in position by pledgets of cotton RADICAL OPERATION. 839 impregnated with aristol or some similar powder. These pledgets arepacked in hghtly until the entire cavity is filled, and the graft is pressedgently against the walls of the cavity in every direction. The raw surfaceleft by cutting the conchal flap is next grafted. This may be done beforethe posterior wound is sutured, by introducing a Thiersch graft into the
. Surgery, its principles and practice . by introducing the pipetcautiously a second or even a third time, exhausting the air. When thegraft thoroughly lines the cavity, it is held in position by pledgets of cotton RADICAL OPERATION. 839 impregnated with aristol or some similar powder. These pledgets arepacked in hghtly until the entire cavity is filled, and the graft is pressedgently against the walls of the cavity in every direction. The raw surfaceleft by cutting the conchal flap is next grafted. This may be done beforethe posterior wound is sutured, by introducing a Thiersch graft into theposterior wound and wrapping it about the cut margin of the concha,so that one edge of the graft lies just within the posterior wound and theother edge projects from the orifice of the external auditory meatus,the graft being wrapped around the cut edge. This is undoubtedly theprocedure of election. In cases in which secondary grafting is to be performed, the technicof the operation is exactly the same, only the procedure is carried out. Fig. 452.—Ballances Instruments for Skin Grafting (Dench).A, Large razor for cutting grafts; B, pipets for removal of air and blood from beneath thegrafts when in position; C, needle for manipulating graft; D, blunt instrument for pressing grafton bony wall and for packing pledgets into tympanic cavity to hold grafts in position; E, broadspatulae upon which graft is spread and from which it is carried into the tympanic cavity. from three to ten days after the primary operation. Whether graftingis employed either primarily, or whether the operator decides to allowthe cavity to heal by dermatization from without inward, the posteriorwound is closed completely in every case of radical operation, except inthose cases in which there has been a considerable exposure of the lateralsinus and where, the disease in the region of the sinus has been so ex-tensive as to render it unsafe to complete^ close the posterior these cases the posterior
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