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Image from page 717 of “Plastic surgery; its principles and practice” (1919)
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Identifier: plasticsurgeryit00davi
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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Text Appearing Before Image:
. 820.—A flap from the under surface of the opposite leg to cover the knee (Maas).Fig. 821.—A flap from the inner side of the opposite leg to cover a defect on the middlethird of the back of the leg. diagonally over the other leg; from the opposite leg for the outer lowerthird, the normal leg being crossed over the ulcerated limb. Allof these^positions may be varied to suit existing conditions. 696 PLASTIC SURGERY ANKLE Loss of Substance.^The foot slightly inverted should be putup at right angles to the leg for all losses of substance in this region.Wounds or ulcers around the ankle and over the malleoli are difiicult toheal. If skin grafting seems inadvisable, a pedunculated flap should beused from the same leg or from the selected portion of the other leg, ifthe wound is of any size. In cases of small losses of substance thesurrounding skin, if normal, may be undercut, and the tissues drawn inand sutured. If relaxation incisions are necessary the resulting defectsmay be grafted.
Text Appearing After Image:
Fig. 822.—Contracture of the knee following an extensive burn. Duration two years.I. Note the extensive destruction of tissue and the areas on the thigh which had been grafted.Also the mass of scar tissue filling the popliteal space and preventing extension. 2 and 3Result of the reconstruction of the popliteal space by shifting in available flaps, and skingrafting the remaining areas. Photograph taken six months after operation. FOOT Loss of Substance.—Wounds on the foot require active assistancein healing if the best functional results are to be obtained. On thedorsum, skin grafting is usually sufficient except over the instep, wherethe result may not be stable unless a whole-thickness graft is employed.In this situation a pedunculated flap from adjacent skin, or from theother leg, may be necessary. On the sole, we frequently have deepdestruction of soft parts, and this is especially serious when it involvesthe covering of the heel and other weight-bearing portions. In thesesitua
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