Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren.

  • Warren, Jonathan Mason, 1811-1867.
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: Rhinoplastic operations : with some remarks on the autoplastic methods usually adopted for the restoration of parts lost by accident or disease / by J. Mason Warren. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    of the interrupted suture. The strip which was to form the columna of the nose was deeply implanted in an opening made for it in the upper lip; the whole was supported by small strips of adhesive plaster, and covered with lint, for the purpose of preserving, as much as possible, its temperature; small tubes were introduced into each nostril, to prevent the adhesion of the oi)posed surfaces. The whole of this long and painful operation was supported with the most admirable fortitude ; and not a single groan was extorted throughout the whole course of it—so that considerable anxiety was experienced, at some periods, that she had fainted, and it was necessary to make fre- quent inquiries to determine whether or not this was the case. During the operation, a number of arteries were cut, and bled freely ; but as it was desirable to avoid the use of ligatures, they were allowed to bleed, until they voluntarily ceased. The patient was directed to keep in bed, to remain perfectly still, and to breathe through the mouth ; in order to favor this, a wedge of cork was secured between the teeth whenever any disposition to sleep was manifested. I saw her four hours after the operation. She then complained of some sense of tension in the scalp, and a slight hemorrhage had occurred from the free edges of the new nose. On the following day the nose was considerably swollen ; pulse 72; she was rather restless. Some inflammation, apparently of an erysipela- tous character, made its appearance about the forehead towards evening; this was attributed, partly, to the want of free ventilation in the room. On the following morning, however, not finding any abatement of the inflammation, I removed all the dressings from the head, together with the pins which confined the edges of the wound in contact. On the 21st, the sutures were removed from the nose, and an entire union to the adjacent parts had taken place. Upon questioning the patient as to the sen- sibility in the new-made organ, she states that it is nearly natural, and but slightly referred to the part from which the skin had been transplanted, as was the fact in the case formerly reported in this Journal. The form of the new nose is good, with a regular curved outline ; the alse nasi, also, are well defined ; the whole, however, still much swollen. The nostrils are kept open by means of the small tubes, which are re- moved daily, and cleansed from the mucous and purulent secretions which tend continually to obstruct their passage. The wound in the forehead was dressed daily with the creosote oint- ment, which remedied, in some measure, the fcEtor arising from the sup- puration of so extensive a wound. The patient also derived much com- fort from a creosote gargle for the purpose of purifying the mouth.