On harelip and cleft palate.

  • Rose, William, 1847-1910.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: On harelip and cleft palate. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    advantage of this is that when introduced quite close to the edge of the palate^ its blunt concave border directed towards it has no tendency to cut its way out, whilst the convex cutting edge makes a track for the needle and suture to follow. It is manifest that the incision thus made is at right angles to the margin of the cleft, and consequently Avhen the suture is drawn tight, the tendency is rather to close than to open the needle track. With the old needles making as they did in their passage an incision parallel with the edge of the cleft, the tightening of the suture caused the opening to gape, and this occasionally resulted in the establishment of a fistulous aperture leading to subsequent trouble. (Compare Figs. 64 and 65.) Mr. T. Smith emphasised this point as far back as 1868. {Vide an interesting paper of his in ' Med.- Chir. Trans.,'vol. 51.) Fi&. 64. Pig. 65. Fig. 64.—Shows effect of drawing stitches together when needles cutting parallel to the edge of the cleft have been used, resulting in an oval opening at the site of each needle puncture. Fig. 65.—Contrasts the effect produced when needles cutting at right angles to the cleft margin are used. There is no tendency to opening up of the needle tracks, but rather to close thein. With reference to the sutures, many different materials have been employed, such as silk, silkworm gut, catgut, horsehair, and fine silver wire. For many reasons the silver wire is to 8