Chelius successfully replanted a nose after it had been severed about an hour.
Hoffacker has replanted a number of noses cut off in the duels of Heidelburg students. In one case one and a half hours intervened between the accident and the operation.
In partial separations about the nose the flap, still hanging by a slight pedicle, should be brought in place by suture, and because of the peculiar hypertrophy that always follows the wounds one or two intraflap sutures should be employed to fix the part centrally to the deeper tissues, if any, to prevent the formation of clots that are liable to organize and encourage such enlargement.
Such sutures are only to be made when the flap is of sufficient size to necessitate them. If the hypertrophy or hyperplasia cannot be prevented by this means later cosmetic operations should be employed to make the parts heal into normal contour.
Blood dressings should be employed after the parts have been fixed by a number of fine silk sutures, the coaptation being made as neatly as possible to get the best results.
NASAL TRANSPLANTING
The making of a nose or part thereof from a nonpedicled flap of skin taken from the patient has met with more or less success in the remote past, but of later years such methods have fallen into disuse because of the many and better methods of modern times involving the use of flaps with nutrient pedicles.
Branca is said to have made a nose for a patient out of the skin of the arm of a slave.
Velpeau states that “In the land of the Pariahs the men in power had no scruples in having the nose of one of their subjects cut off to replace the lost organ of another.”