The mucosa of the nose is to be sutured to the raw edge of the flap when that is possible.
Fig. 460. Fig. 461.
Dupuytren Method.
Serre Method.—This author advises dissecting up a flap from the upper lip, including the skin only, leaving it attached just above the vermilion border, as in [Fig. 462].
The free and upper end is sutured to the lobule. When union has taken place, the pedicle is divided and is brought upward and sutured into place. The secondary wound repaired by suturing finally. There is some difficulty in dressing the wound during the time required to have it unite to the skin of the lobule, because of the danger of pressure and consequent gangrene.
Fig. 462.—Serre Method.
Dieffenbach Method.—This author took up the skin flap transversely or obliquely, as shown in [Fig. 463], and twisted it into position, as shown in [Fig. 464].