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 . Fig. 232.— V-flap, excision of wedge of tarsus and canthoplasty. should be closed with care and a compress lightly bound over theeye. The eye need not be examined for two or three days, andthe lead plate may be left undisturbed for a week. The disfigurements due to adhesions of the lids and the bulbarconjunctiva should always be remembered when recen
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 . Fig. 232.— V-flap, excision of wedge of tarsus and canthoplasty. should be closed with care and a compress lightly bound over theeye. The eye need not be examined for two or three days, andthe lead plate may be left undisturbed for a week. The disfigurements due to adhesions of the lids and the bulbarconjunctiva should always be remembered when recent injuriesof these structures are first seen. Careful suturing and applica-tions to prevent contact of raw surfaces should be a feature ofthe treatment when ankyloblepharon or symblepharon is a possibility,possibility. Either of the lids may be turned out so as to expose the mucoussurface. The lower lid is the more frequent seat of the displace-ment. An overflow of tears is apt to occur if the lower lid beaffected. Chronic eversion is followed by thickening of themucous membrane. The cornea may become ulcerated because. Fie. 233.— Temporal flap to correct ectropic 400 WAR SURGERY OF THE FACE. its surface is not kept free of irritating particles by means of thenormal wiping of its surface by the close-fitting lids. Ectropion of the lids may be caused by loss of power in theorbicular muscle, as in palsy of the facial nerve and in the weak-ness of the muscle fibers incident to old age. It results also fromtraction of scar tissue on the front of the lid, and from pressurefrom behind, as in exophthalmos, in tumors of the eyeball and ingrowths of the conjunctiva or lid itself. The worst deformities of this character are seen after cicatricialcontraction has occurred subsequent to sloughing due to burnsof the cheek and forehead. In many of these patients portionsof the lids have been lost by the gangrenous process and fibrousscar tissue has caused great distortion of the remaining
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
