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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ly if necessary.)By these incisions two flaps are outlined on each side of the urethralgroove, one having its base at the urethral groove, while the other is inthe skin of the body of the penis. These flaps are raised and those with their bases at the urethral groove are turned over a rod or rubber tube, 21 322 PLASTIC SURGERY SO that the skin surface is next to the rod. I prefer to make these edgesmeet and to suture them separately over the tube with fine catgut. Inthis way the urethra is completely lined with epithelium. The outsideflaps are then brought in and closed with horsehair sutures. I havenot found it necessary to use the lead plates advised by some authorsfor securing these sutures. After healing is complete and all indurationhas disappeared, the extremities of this newly formed urethra arejoined above and below to the other channels (Fig. 286). Bucknalls Operation. First Stage.—The penis is drawn up onthe abdomen and the scrotum is drawn down between the thighs, so that
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Fig. 285.- -Operation for hypospadias, continued (Bevan).—The skin of the penis drawnin and sutured over the defect left by raising the flap. the tissues are on a stretch in the midline. Then a longitudinal inci-sion is made on each side of and 0.312 cm. (>^ inch) from the midline,extending from the glans to the abnormal urethral orifice. The inci-sions are now lengthened on each side of the scrotal raphe until thosebelow the urethral orifice on the scrotum are exactly the same length asthose on the penis. This outlined area of skin 0.625 cm. (3>^ inch) wide(with the urethral orifice in the center) is allowed to remain undisturbed.From the extremities of the longitudinal incisions already made, other HYPOSPADIAS 323 incisions 0.625 cm. di inch) long are made at right angles, and the flapsthus marked out are raised on each side and rolled back. In this wayare formed two long denuded strips 1.25 cm. (^2 inch) wide on eachside of the undisturbed skin in the midline. The flaps are

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