A Manual of Operative Surgery V

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: 10 CHAPTER IL Plastic Operations For The Relief Of Cicatricial Deformities After Burns. The more gross variety of deformity which results from the contraction of the integuments after severe burns has been the subject of a great number of methods of treatment It must be confessed that the results obtained...
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Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: 10 CHAPTER IL Plastic Operations For The Relief Of Cicatricial Deformities After Burns. The more gross variety of deformity which results from the contraction of the integuments after severe burns has been the subject of a great number of methods of treatment It must be confessed that the results obtained have not been proportionate to the ingenuity and patience expended upon the treatment. The contractions with which this chapter is mainly concerned are situated in the neck, face, or upper extremity. Various methods of extension, by means of screw apparatus, india-rubber bands, weights, etc., have been tried, but with little success. The same may be said of the treatment which consists in dividing the main contracting bands. Every variety of incision has been employed, a single large incision, multiple small incisions, subcutaneoiis sections, and cuts that have been placed in various relations with the line of the contracted band. This method has been combined with extension and with forcible rupture, and has been aided by skin grafting, and every known means of securing rapid and complete healing. The cicatrix has been entirely excised, and the gap left allowed to heal by granulation, or it has been partially excised, or has been so dissected up as to allow the contracted band to remain as a species of flap. In these operations attempts have been made to lessen the area of the granulating surface by lateral incisions of various kinds made through the adjacent sound tissues, or by subcutaneous detachment of those tissues in one way or another. In instances in which the deformity has attained to any magnitude it must be owned that these operations have met with but discouraging or very imperfect results. Lastly come the various methods of dealing with t...