This operation is useful only in older children, and has the disadvantage of requiring a secondary interference. The results are not as good as those obtained with the operations mentioned previously, leaving, besides, a disfiguring cicatrix at either border of the alæ, a serious objection, especially to the cosmetic surgeon.
Post-operative Treatment of Harelip
When the operation has been performed in the infant the wound is simply kept clean by the local use of warm boric-acid solutions and the mouth is cleansed from time to time by wiping it out with a piece of gauze dipped into the solution.
Children do not bear dressings of any kind well, although Heath employs strips of adhesive plaster to draw the cheeks together to relieve tension on the sutures.
To keep the child from tearing or picking at the wound Littlewood advises fixing both elbows in the extended position with a few turns of a plaster-of-Paris bandage.
Everything should be done to keep the child quiet, as crying often results in separating the wounds. This is accomplished by giving it milk immediately after the operation. The mother must ply herself closely in soothing the child by carrying it about, rocking, and feeding it.
The feeding should be done with the spoon. Dark-colored stools containing swallowed blood will be passed in the first twenty-four hours; to facilitate this a mild laxative, such as sirup of rhei, can be given.
In older children a compressor can be applied to the head. That of Hainsley, shown in [Fig. 197], answers very well, yet adhesive plaster dressings, if carefully removed later, are most commonly used.
