Observations on the operative measures necessary in the treatment of hare-lip / by Richard G.H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the operative measures necessary in the treatment of hare-lip / by Richard G.H. Butcher. 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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    Case VII.—Simple Hare-lip, complicated with a very remark- able arrangement of its parts ; successfully operated on at the age of six weeks, and cured without deformity. I select this case from amongst many, as presenting some fea- tures peculiar and different from what are usually met with. The case occurred in private practice. The child was a female, the fourth born of an exceedingly handsome lady; all the other children were well developed and robust. The little patient was not six weeks old when sent from England for my opinion during the past summer. The condition of the upper lip was very peculiar: a short but wide fissure cleft the lip through its red border and for a short distance higher, in all half an inch. Wide and gaping to a like extent was the separation, while continued upwards close to the nostril was a sulcated seam, the right side elevated above the other, more prominent, and on the whole better developed. Thus, though the absolute cleft was small, and a good deal concealed when the child laughed, yet when the features were in repose, the deformity was very conspicuous. On turning up the lip and examining it care- fully, a white line shining through the mucous membrane marked its course, while the latter structure lay smooth and polished over it. It absolutely had all the appearance as if na- ture had repented of her error, and too late put forth every en- deavour to seal the part. The ala on the left side was also drawn down or depressed. In the operation it was necessary to prolong the incisions into the nostril, excise the seam to- gether with the margins of the cleft lip, and at the same time raise the ala from its deep attachment. Two needles were ne- cessary for the retention of the parts, and two points of inter- rupted suture, one placed between the needles, the second one on the inside of the red border of the lip. The needles and points of suture were removed sixty-seven hours after the ope- ration, the threads, in the form of the figure of oo, being allowed to remain, and their adhesion assisted by the application of collo- dion. On the following morning the threads readily came away, and nothing could be more perfect than the union from the very angle above through the entire extent and depth of the lip to the mucous membrane covering in its red margin. Before and behind all was accurately united, and in a week after, the needle-holes were filled up and healed, the cicatrix being pale and not con- spicuous to the observer when standing a few feet from the child.