On restoration of the upper lip / by R.J. Mackenzie.

  • Mackenzie, R. J. (Richard James), 1821-1854.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: On restoration of the upper lip / by R.J. Mackenzie. Source: Wellcome Collection.

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    The lines in Fig. 3 will serve to explain the situation of the in¬ cisions by which this object is attained; and if the method of opera¬ tion I have described is thought worthy of performance, this modi¬ fication of it (the preservation of the prolabium in situ) will be found of the greatest advantage in obviating the contracted state of the mouth. The second case, in which a somewhat similar operation has been performed, was that of a girl, of eight years of age, who, when two years old, suffered in a similar way to the preceding case, from mor¬ tification of the face during fever. The same parts were destroyed as in the case I have related; but the left half of the upper lip had retained its vitality. The whole of the soft parts, however, between the eye and the lower lip had been lost, a small portion of the lower eyelid at the outer angle only remaining. From the contraction during cicatrisation, the remains of the angle of the mouth had been drawn upwards close to the eye. The nose, too, had been entirely destroyed. In this case I attempted to restore the lost parts by bringing up a large flap, consisting of the lower lip (saving the pro¬ labium, as in Fig. 3), and integuments over the base of the jaw, so as to fill up the whole gap at once; but the result of the operation was unsuccessful, from an unforeseen accident. From the effects of the chloroform, which had been administered pretty freely during the time of the operation, the poor child vomited, with little cessa¬ tion, for thirty-six hours. From the long-continued drag thus made on the sutures, union failed in the entire extent of the wound, and the flap, in spite of all means used to keep the edges together, gra¬ dually retracted and receded from the surface to which it had been attached. By a second operation, however, the flap was united to the remains of the upper lip. The upper lip has thus been com¬ pletely replaced, and, from the preservation of the prolabium (as