Improvements in Reconstructive Surgery of the Head.

Surgeons are gradually coming to appreciate the immense value of prompt plastic reconstruction.Practically all tissues can be repaired by plastic procedures, if the operative technic is mechanically efficient, provided that the wounds be kept aseptic from the moment of their production to the end of the period demanded by nature for the metabolic rees tablishment of function.The greatest adversary in plastic surgery is bacterial infection.Tension on sutures and too early disturbance of the repaired tissues should be avoided as carefully as possible.The usual methods are : A. Displacement : (1) approximation ; (2) sliding to transfer tension.B. Interpolation, borrowing material from vicinity, from another region, or from another person or animal.C. Enthesis : burying in the tissues foreign bodies, such as paraf fin, wire, metal, glass, rubber.D. Retrenchment : cutting out ellipses or wedges.E. Substitution.F. Strategic : temporary displacement, as mandible to get at pharynx ; zygoma and cranium to reach brain.In complicated procedures, a series of operations extending over many months may be necessary; too much should not be attempted at a time.New Ideas in Plastic Surgery of the Head.Prompt readjustment of tissues and immobilization are two important factors in war surgery.Mandibular war fractures are usually both comminuted and in fected.Immediate removal of all foreign bodies, displaced teeth, unattached splinters of bone, and prompt fixation are most advisable.