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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t operative method of treatment was the division (eithermultiple or single) of the contracting bands down to normal tissue,and long continued over-correction of the head. If bands subse-quently formed, they were divided as often as necessary, but thismethod was tedious and the results were generally unsatisfactory. Pedunculated flaps of the scar tissue have been shifted in variousways to relieve the contracture, and the head placed in an over-corrected 6l2 PLASTIC SURGERY position. But almost invariably sloughing of the flap occurs and re-contracture frequently follows. Unless the scar is thin and very mov-able, it is useless to attempt to utilize it. On several occasions I havebeen able to shift successfully a scar of this type in the form of a widedouble-pedicled bridge flap, but when normal tissue is available oneshould never employ flaps of scar tissue. Excision (partial or complete) of the contracting scar is therational method, the defect being covered with skin grafts or with a
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Fig. 707. Pig. 708. Pig. 707.—Method of utilizing a flap from the back for the relief of a neck defect (Ber-ger).—The dark lines outline the flap A with its pedicle on the neck at the margin of thedefect. This flap can only be used to cover one-half of the neck, or possibly a little more.The dotted lines mark out the flap B, which is brought forward on the other side to completethe collar of normal skin, if the defect covers both sides. The raw surface on the backshould be grafted. Pig. 708.—The use of flaps from the arms for the relief of contracture of the neck.—The free ends of the flaps A and A raised from the front of the arms and shoulders aresutured in the midline, after dividing the contracting scar. The raw surfaces B and Bshould be skin grafted. Crofts plan may also be used in this type of flap. pedunculated flap. Flaps may be taken from the shoulder, the arm,the chest and the back, and should consist of the skin and subcutaneousfat. Partial Gradual Excision.—I hav

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