Identifier: plasticsurgeryit00davi (find matches)
Title: Plastic surgery; its principles and practice
Year: 1919 (1910s)
Authors: Davis, John Staige, 1866-1933
Subjects: Surgery, Plastic
Publisher: Philadelphia, P. Blakiston's son & co
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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to befolded on itself after healing is complete in the upper flap. 3 and 4. Process completed.The drawing idealizes the result. The operation as it was originally proposed is of little practical use,but its cosmetic value can be enhanced by utilizing shaped rib cartilagefor a supporting framework. I have done this on several occasions with a fair degree of success,but have as yet not completed the ear on any single case, as these 412 PLASTIC SURGERY patients are still returning from time to time for further operative work.Although it might seem a simple procedure it is quite difhcult to keepthe main portion of the flap, which is to form the auricle, from adheringto the head, except at the margin. I have tried to overcome this bygrafting the raw surfaces, but without complete success. The best method is by swinging up a pedunculated flap from theneck and suturing it to the posterior portion of the auricle, after dis-secting it well away from the head. Ten days later the pedicle is cut.
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Pig. 416.—Congenital malformation of the ear.—i. The rudimentary ear. There isdefinite atrophy of the face on the left side. 2. The normal ear is very prominent.Note the deficiency in the mastoid region as compared with the right side. 3. The bodyof the prospective ear has been formed from a flap raised from behind the rudimentaryear and it has been braced with pieces of cartilaginous rib. There is much difficulty inkeeping this portion from close adherence to the head. To overcome this a flap has beenturned up from the neck, and sutured in such a way as to line it. The flap in place. Notethe tooth picks inserted between the flap and the head to show the depth of the lining. I have transplanted a cartilaginous rib for a framework at the timeof raising the flap, including it between the raw surfaces where the flapwas folded. At other times I have waited until the surfaces had growntogether and then inserted the cartilage in channels burrowed betweenthe flaps. It is difficult to sec

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