Fig. 95. Fig. 96.
Fricke Method.
The lids are temporarily sewed together, thus stretching the defect fully into which the flap is to be sutured. The pedicle is severed after thorough circulation in the flap has been established.
Owing to the free movement of the skin over the temporal fascia, the wound formed by the incision of the flap can be entirely closed by a single line of interrupted sutures.
Ammon and Von Langenbeck Method.—A very similar method, especially devised for the correction of extensive ectropion of the lower lid, is that in which the pedunculated flap is taken from the latter aspect of the cheek.
A curved incision is made just below the tarsal border, freely loosening the attached conjunctiva in this manner. The cicatricial tissue or other cause of the defect is thoroughly excised and the lids fixed together by suture.
The wound is then fully exposed. A curved incision, as shown in [Fig. 97], is now made, with its base in line with the superior line of the raw surface. It is carefully dissected up and twisted into position and held by suture ([Fig. 98]).
Fig. 97. Fig. 98.