Fig. 392.—Bringing Down Frontal Flap.
The free margins of skin remaining at the septal bone of the flap are folded inward to line the new nostrils. Catgut sutures are used to keep these folds in position.
The nose is now ready to be sutured into place. The subseptum is inserted first and fixed into the upper lip, then the nose being held so that its median line occupies the proper position, both wings are sutured to the freshened margins, and lastly the sides (see [Fig. 393]).
Fig. 393.—Placing of Frontal Flap.
The frontal wound may be drawn together as near as possible by suture.
Rubber drainage-tubes are kept in the nares for a few days, and are thereafter replaced by rolls of gauze.
Dry dressings are preferred for the nasal wounds, which heal in about five days.
A month after, Thiersch grafts are employed to cover the frontal wound remaining. They require about eight days to heal into place.