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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    lengths and thickness. I generally use the size represented in the woodcut. It is a long, slender needle, ground into a tri- angular shape from its point upwards, for half to three-quarters of an inch. Owing to its great length it is easily introduced, and very manageable after transfixion. It will rest in the wound without falling out, owing to its length, until other parts of the operation are proceeded with; and from the deli- cacy of its form, and the sharpness of its point and edges, it traverses the lip with the least possible violence; it is so thin, round, and polished on its surface, it produces scarcely any irritation. After the silk is thrown around it, the point and eye are easily clipped off; and lastly, when the time for its removal comes, it is easily withdrawn without jerking or shaking the parts. In the application of the twisted suture, I would insist upon the following particulars being attended to:—First, the needle must be introduced a considerable dis- tance from the edge of the lip, and not, as in accordance with the rule usually laid down, “that the point of entrance must be at a distance from the edge, equal to the thickness of the lip.” By piercing far away from the cut edge, the needle is permitted to pass close to the mucous membrane without dipping, and not, as generally advocated, two-thirds through the substance of the lipa. Second, when the silken cord (which should be coarse) is about to be cast around the needle, in the figure of eight form, before any restraint is made by it, the cheeks should be shoved forwards by an assistant standing behind the child, and the cut surfaces absolutely in contact; the parts thus held up together are gently restrained by the turnings of the cord from retracting or receding into their original position, but there is no uneven constriction exerted on them, as occurs when they are forced together by the tension of the ligature as generally applied. As the result of the former mode, but little force is required to keep the parts in situ, therefore the needles are not dragged forwards, or made to pro- duce an injurious pressure on the transfixed parts, terminating in ulceration; thus, through the entire depth of the wound adaptation of surfaces is insured with the slightest amount of a Cooper’s Surgical Dictionary, p. 658, Seventh Edition.