The secondary wound is easily brought together by suture, as the skin is quite flexible at this point.
Fig. 454. Fig. 455.
Author’s Case.
Restoration of Nasal Lobule
This defect of the nose has been restored by the use of skin flaps taken from the forehead, the nose itself, or from half or the whole thickness of the upper lip. The author does not advocate the use of such flaps except those taken from the skin of the inner side of the forearm, just below the wrist, made according to the Italian plan, as heretofore described.
The pedicle of such a flap is cut about the twelfth day, and at a later period, when the inferior or free margin has cicatrized, the subseptum is formed and sutured to the remaining stump or into a wound in the upper lip made to receive it.
The skin of the forearm is nearer to the thickness of the skin of the nose; hence a flap from it is preferable to that taken from the arm.
The method of obtaining the flap has been fully described heretofore.