A Wonderful New Surgery that Will Leave no Ugly Scars.

New Zealand Graphic, Volume XXXVII, Issue 9, 1 September 1906, Page 33

A Wonderful New Surgery that Will Leave no Ugly Scars.

Staking a fine art out of surgery is the latest development of that science, which, nowadays, saves so many lives at a minimum cost of anxiety and pain. Most persons afilietrd in a way that only an operation can remedy, are glad enough to be restored to health, and probably give little thought to probable disfigurement. But even this comparatively small disadvantage has inspired I)r. J. L. A. Aymard, a- noted hospital surgeon of London, to experiments which have proved that surgical scars are unnecessary. He finds that it all depends on the manner in which the ineision through the skin is made. His own description of his searless method is reprinted here from the London Lancet: “ My new method of skin division consists of the simple operation of dividing it upon the slant in contra distinction to the present method of dividing the same at right angles to the surface. My idea, though new by design, is by accident of very ancient origin. There are few of us who have not on our person some example, however small, of this cut through the skin upon the slant. Such a cut-, if extensive, generally presents a somewhat lumpy appearance, d-ue to contraction and very often a smooth mark at the line of junction. It is a skilled application of the principle with scientific correction of the defects which gives results entitling such a heading as appears to this article. “ The reason why a cut through the skin upon the slant and subjected to properly applied pressure heals so perfectly is not. far to see. Contract is perfect and the greater the pressure within limits the better it is. I have proved beyond doubt granulation growth can be controlled by pressure, and was, therefore, not in the least surprised to get sueh good results from this new incision. The ordinary process of healing proceeds as usual, but granulation tissue with subsequent fibrous and scar tissue is reduced to a minimum. The sear is present hut hidden away, and, if I may quote, • What the eye does not see the heart does not grieve.’ ’• “ It is of tlie greatest importance that we should grasp what takes place. The apex of the upper flap at once retracts and becomes wrinkled, curling inwards or outward according to the region of the ineision. The apex of the lower flap takes, as a general rule, a conical form. In the subsequent approximation these points should be borne in mind. It is not sufficient simply to adjust the wrinkled apex of the top flap. “ With regard to tire operation itself, tire skin should be reasonably stretched in all directions by assistants if this is not already the case by some underlying tumour. The angle at which the knife should be held can only be learned by practice. The skin, as a rule, will give live or six millimetres or about a quarter of an inch, flap, but in addition at least as much fat flap, except, of course, when the fat is excessive. Fat makes firm, rapid union, and is, therefore, of considerable importance. “ Sometimes I secure the wound by placing across a few strips of China silk and collodion, at others by merely placing collodion ou tin* curved or flat glass dressing. When the glass is pressed flat the exact position of the flap can be seen at a glance. I prefer glass to celluloid or mien because it is rigid, a matter of importance when applying pressure. In all probability excellent, results will be obtained in a dozen other ways. “ With regard to pressure, it should be slight for the first few days, then gradually increased. Whichever rigid dressing is placed over the wound it should be covered by a large pad of wool. If no rigid dressing is thus used in all probability a contracted condition of the flap will result. Sooner than allow a wound to heal in bad position I would always break it duwu aud begin again.”