Chirurgia plastica; i suoi principi e pratica . ompleta escissione. Il trattamento di ulcere croniche mediante stiramento del nervo.--Smitsreports favorevoli risultati seguenti stiramento del nervo nervo e laceranti(mediante i metodi suggeriti da Chipault), nel trattamento di perforatingulcers del piede, e di alcuni tipi di ulcere varicose, che egli ha anche believesto essere trofica in origine. Piccoli e Fontana era successo anche withthis metodo nel trattamento di ulcere di perforazione del piede. Veyrassat andSchlesinger resecata la S3mpathetic nervi nella guaina di quella femorale t8o chirurgia plastica arteria in triangolo Scarpas

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Plastic surgery; its principles and practice . omplete excision. The Treatment of Chronic Ulcers by Nerve Stretching.-—Smitsreports favorable results following nerve stretching and nerve lacerating(by the methods suggested by Chipault), in the treatment of perforatingulcers of the foot, and of certain varicose ulcers, which he also believesto be trophic in origin. Piccoli and Fontana were also successful withthis method in treating perforating ulcers of the foot. Veyrassat andSchlesinger resected the S3mpathetic nerves in the sheath of the femoral t8o PLASTIC SURGERY artery in Scarpas triangle, and also reported good results in perforatingulcer of the foot. The same method has been used in the treatment ofulcers in other parts of the body (Fig. 122). Nerve stretching or laceration was done only in cases in which theordinary methods of treatment had failed. In addition to the nervestretching, the ulcer was excised and the defect closed by plastic opera-tion or skin grafting. Varicose veins were also dealt with by surgicalmethods.. Fig. 122.—Trophic ulcer of the foot.—An ulcer of this type is difficult to heal. Restin bed, constitutional and local treatment being the best preliminary steps. Later ifconditions are favorable, nerve stretching with grafting of the granulating surface, orexcision and the implantation of a pedunculated flap. In the perforating ulcers of the foot, in various cases the followingnerves were either stretched or lacerated: the external saphenous, theposterior tibial, the musculo cutaneous, the plantar, the external pop-liteal, and the sciatic. In varicose ulcers the following nerves were either stretched orlacerated: the internal saphenous, the external saphenous, the externalpopliteal, and the sciatic. I have had no experience with this method, but it seems rational, especially for trophic ulcers. The radical operative procedures used INTRACTABLE ULCERS AND VARICOSE VEINS l8l in conjunction with the nerve stretching may have a good deal t

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• bookcentury1900
• bookdecade1910
• booksubjectsurgeryplastic
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