Surgery and Healing in the Developing World - Dartmouth-Hitchcock
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Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Surgery and Healing in the Developing World - Dartmouth-Hitchcock Surgery and Healing in the Developing World - Dartmouth-Hitchcock

dartmouth.hitchcock.org
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21.06.2013 Views

Reconstructive Surgery in the Tropics Figure 59. After dissection of skin flaps, testicles, and urethra with catheter tourniquet. Figure 60. Postoperative appearance of the same patient. 271 The flaps are now brought together to cover the shaft of the penis and to cover the testicles which are replaced in their normal position. This is done with deep interrupted absorbable sutures. The skin is approximated around a penrose drain. Estlander-Abbe Flap (Figs. 61-66) This flap is used for establishing oral continuity after traumatic or operative loss of the lip and mouth margin. One-third of either the upper or lower lip is used to replace up to one half of the opposite lip and mouth margin. It works because the marginal labial artery, which runs on the inner surface of the lip, can easily support the circulation of an entire segment of the lip. If this vessel is carefully preserved, the lip section can be moved with ease to its new and needed position without difficulty as shown in the accompanying picture. 26

26 272 Surgery and Healing in the Developing World Figure 61. Left lower lip squamous cell cancer without positive nodes. Figure 62. Estlander-Abbe flap from left upper lip based on labial artery. Figure 63. Estlander-Abbe flap 3 weeks after placement.

26<br />

272 <strong>Surgery</strong> <strong>and</strong> <strong>Heal<strong>in</strong>g</strong> <strong>in</strong> <strong>the</strong> Develop<strong>in</strong>g <strong>World</strong><br />

Figure 61. Left lower lip squamous cell cancer<br />

without positive nodes.<br />

Figure 62. Estl<strong>and</strong>er-Abbe flap from left<br />

upper lip based on labial artery.<br />

Figure 63. Estl<strong>and</strong>er-Abbe flap 3 weeks after<br />

placement.

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