Plastic surgery; its principles and practice . tures. retaining stitch of horsehair through each side of the mucous membraneof the lip close to, but below, C and C. The lip is transfixed with anarrow-bladed knife at B, and the knife is carried with a sawing sweepin a slight curve to A, where it emerges exactly at the shoulder. The HARELIP AND CLEFT PALATE 267 lip is then divided along the line BC and the tissue outlined by ABC isremoved. The same maneuver is carried out on the opposite side ofthe cleft, the knife passing along the line ABC. As a result we now have two raw surfaces opposed to o
Plastic surgery; its principles and practice . tures. retaining stitch of horsehair through each side of the mucous membraneof the lip close to, but below, C and C. The lip is transfixed with anarrow-bladed knife at B, and the knife is carried with a sawing sweepin a slight curve to A, where it emerges exactly at the shoulder. The HARELIP AND CLEFT PALATE 267 lip is then divided along the line BC and the tissue outlined by ABC isremoved. The same maneuver is carried out on the opposite side ofthe cleft, the knife passing along the line ABC. As a result we now have two raw surfaces opposed to one another,the corresponding sides of which are equal in length. Thus AB isequal to AB, and BC is equal to BC. If A be united to A\ and B to B, and C to C, the sides of the woundbetween these points can be brought into apposition with accuracy anda perfect lip will result, such as is shown diagrammatically in 3. In 4 the same operation is shown on a lip in which the sidesof the cleft are divergent. In order to get sufficient depth to the lip,. (4) <6) Pig. 227.—Diagrammatic representation of Thompsons operation for single and doubleharelip.—A full description will be found in the text. the points B and B will necessarily be very far apart, but can be broughttogether with very little tension if the cheeks have been well loosenedbeforehand. Otherwise the steps of the operation are identical withthose shown in 2 and 3. The treatment of double harelip is shown in 5 and 6. The shoul-ders marking the margins of the nostrils are shown at A and E, andat A and £. The triangle EDE shows the line of incision by whichthe central piece of skin covering the intermaxillary bone is and E are placed on the inner margins of the nostrils. The sidesDE and DE are usually equal in length to one another, and theirlength varies according to the depth of the central piece of skin. Itmust never be greater than AB and is usually much less. The pointsA, B and C, and A, B\ and C, are chosen
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