Hypertrophies and degenerations of cicatrices and cicatricial tissue / by John Collins Warren.

  • Warren, John Collins, 1842-1927.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Hypertrophies and degenerations of cicatrices and cicatricial tissue / by John Collins Warren. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    few hours at a time will be sufficient. For old scars he advises excision ; slight scars can often be removed by actual cautery. Unna1 recommends for the treatment of depressed scars of the face friction with sand to prevent the undue accumulation of the horny layer of the epidermis. A case of scars produced by pustular acne was treated successfully in this way. After a few months of this treatment it was found that the depressed scars on the nose were shallower and smaller in diameter, and were scarcely perceptible. In a case of smallpox scarring, in a woman twenty years of age, three months of the friction treatment made the skin smooth. The situation of the previous depressions was marked by less pigmented circular spots. Unna employs finely powdered marble. He prepares a “ pulvis cutifricius ” of two kinds. The powder may be used alone or mixed with powdered soap, sulphur or other powders. It should be applied as a lather. The action of the carbonate of lime has probably some beneficial effect. A fine sponge is dipped in the powder and the diseased parts are polished with it, at first slowly, later more rapidly but lightly, more as one would polish a boot. The frictions should be employed for ten to fifteen minutes once or twice a day. Depressed cicatrices from gunshot injury, disease of the bone or of the glandular structures of the neck are often the cause of considerable deformity. An operation for their relief has been planned and successfully carried out by William Adams.2 This consists in the subcutaneous division of the scar with a fine tenotomy knife. Two or three punctures may be necessary to liberate extensive scars. The cicatrix should then be carefully everted, and while held in that position two hair-lip pins or finer needles are passed through its base at right angles to one another so as to maintain the cicatrix in its everted or raised form for three days. Adams reports several cases in which the depression had not reappeared several years after the operation. Pigmentation of the cicatrix may be due to various causes. That produced by the presence of particles of powder is most con- 1 Unna, Vierteljahr. fur Derm, and Syph., Vol. VIII, p. 508. 2 London, J. and A. Churchill, 1879.