La chirurgie plastique ; ses principes et pratiques . proche parent de l'autre côté de l'avant-bras a été déplacé plus de deux volets à remplir l'anomalie, les matières de surface est recouverte de petits greffons profonde. Ce cas inhabituel de l'Isan, dans la mesure où même si le patient était apparemment bien nourris il wasabsolutely pas de graisse sous-cutanée sur la paroi abdominale. Le résultat final a été sat-isfactory. Fonction est beaucoup améliorée, et il n'y a plus tendance à l'ulcération. Placez la pièce est progressivement étendu, et il dit que susciter temps ni-mal de poste peuvent être garanties par l'étirement progressif de la peau.Il ha

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Plastic surgery; its principles and practice . kin on the other side of the forearm was shifted over intwo flaps to fill the defect, and the raw surface was covered with small deep grafts. This isan unusual case, inasmuch as although the patient was apparently well nourished there wasabsolutely no subcutaneous fat on the abdominal wall. The ultimate result has been sat-isfactory. Function is much improved, and there is no further tendency to ulceration. place the part is gradually extended, and he says that indue time nor-mal extension can be secured by the gradual stretching of the skin.He has utilized this method at the junction of the thigh with the body, 652 PLASTIC SURGERY and in the popliteal and cubital spaces. In my experience this operationis not entirely satisfactory, unless the excised area is comparativelysmall. FOREARM Loss of Substance.—Destruction of tissue on the forearm mayfollow injury, burns, ulceration or operation. The treatment dependsto a large extent on the size, situation and shape of the defect, and the. I 23 Fig. 762.—Contracture following burn of the forearm and wrist of a child aged fourteenyears. Duration twelve years.—i. There is shortening of the forearm and bowing of bothbones, with flexion of the wrist and marked outward deflexion due to dense scar tissue.2. One month after excision of the scar and the implantation of a pedunculated flap of skinand fat from the abdomen. 3. One year later. The wrist is now in normal position;the radius and ulna are practically straight, and function is much iraproved. Note thesize and splendid condition of the flap. If necessary the marginal scar can be made lessnoticeable later, by excision. condition of the surrounding skin. For instance, if the defect is parallelto the length of the forearm, is not too wide, and the surrounding skinis normal, it may be closed by undercutting and sliding, either withor without relaxation incisions. Skin grafts or pedunculated flaps maybe used in suitable case

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