War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . ufficient skin and fascia have beendissected from the skin of the lid to make the depth of theaffected lid correspond to a normal upper eyelid. All of thewounds are then neatly united by sutures. The tongue shouldhave the part of its skin surface which is to be buried denuded ofthe epithelium. 392 WAR SURGERY OF THE FACE. Instead of using this tongue
War surgery of the faceA treatise on plastic restoration after facial injury by John BRoberts ..Prepared at the suggestion of the subsection on plastic and oral surgery connected with the office of the surgeon generalIllustrated with 256 figures . ufficient skin and fascia have beendissected from the skin of the lid to make the depth of theaffected lid correspond to a normal upper eyelid. All of thewounds are then neatly united by sutures. The tongue shouldhave the part of its skin surface which is to be buried denuded ofthe epithelium. 392 WAR SURGERY OF THE FACE. Instead of using this tongue of skin to make the connection, itwould seemingly be easy to dissect through an incision on theforehead a band of muscle, and carry it through a tunnel to bestitched to the tarsal cartilage, in a manner similar to the methodof transplanting tendons of the hand and foot. A more elaborate operation than those described utilizes asmall strip of tendon taken from the superior rectus muscle ofthe eyeball. This is cut from the middle of that tendon, afterincising the conjunctiva. It is carried up through the undersurface of the everted upper lid and its elevator tendon, near theupper margin of the tarsal cartilage, by means of a mattress -¥-*-. Fig. 224.— Tansleys operation for ptosis. suture with a small needle on each end. The end of the tendonto be transplanted is then drawn into a pocket prepared for itand is attached to the tarsal cartilage near the insertion of thetendon of the weak elevator of the lid. Finally the two ends ofthe suture are brought through the skin of the upper lid at pointsslightly separated from each other and are tied. This operationrequires considerable operative skill and leaves for a time doublevision, due to the post-operative weakness of the muscle whichrolls the eyeball upward. Perhaps a better method in the severe cases of ptosis is thatwhich shortens the suspensory ligament of the lid by means oftwo buried mattress sutures. By these stitches the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
