Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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ly movable,the necessity for skin grafting rarely arises, and with few exceptions, necrosis of theflaps does not prolong convalescence. When it is evident that the described method will not suffice, it may be necessaryto resort either to some plastic means of wound closure, the success of which will dependupon the ingenuity of the operator, or to skin grafting. The incision is begun on the arm at a point opposite the insertion of the pectorahsmajor muscle at the level of the anterior edge of the deltoid muscle. It is carried upwardand inward well onto the shoulder to a point about two inches beyond the line of theanterior axillary margin, and then in a gradual curve, the concavity of which is out- CARCINOMA 589 ward, is continued to within two inches of the upper margin of the breast. This in-cision is placed well within the line of the anterior axillary margin so that the resultingscar will not cross the axilla obliquely and act as a band binding the arm to the side ofthe chest wall.
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Fig. 210.—Showing the skin incision. The dotted lines indicate that part of the skin incision that ismade after the axillary dissection has been completed. Two incisions are made to diverge from the lower end of that just described; thesetogether form an inverted V the limbs of which are made to encircle the upper segment ofthe breast. It is our custom to mark out the remaining portions of the incision withoutcutting through the whole thickness of the skin as is done with the upper portions ofthe incision, the knife being merely permitted to cut through the epidermis. These 59° THE BREAST superficial markings simply continue the upper incisions around the breast and are madeto converge at a point about two inches below its lower margin, whence a single incisionis carried downward and inward in the midline of the rectus abdominis muscle to a

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