Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
That all prothetic preparation of the nature in hand should be placed in
the barrel of the instrument in liquid form is essential, in that the
syringe is thus filled to its required height evenly, and devoid of air
spaces, yet in the light of the best and most successful results the
mass should be allowed to cool and be ejected in semisolid state from a
specially constructed instrument, to be described later.
With such method it is impossible to have an occlusion of the needle
at any time, and the objection of sudden outbursts of unknown and
undesirable quantities of the mass is entirely overcome.
=15. Absorption or Disintegration of the Paraffin.=—The question of
the ultimate disposition of paraffin, injected subcutaneously for any
purpose, has been an extensive one in which many operators have taken
part.
Gersuny at first claimed an encapsulation for the injected mass of
vaselin, which he states was not taken up by the lymphatics, but remained
_in situ_ as an inert, nonirritating body. Shortly after it was shown
that the encapsulated mass soon became ramified by newly formed, fine
bands of connective tissue, which developed more and more in the part
until the entire mass had become displaced by this tissue with an
eventual consistency of cartilage.
Eckstein claims that at first a capsule of new connective tissue incloses
the injected mass (Hart paraffin) a few days after the latter is
injected, which can be easily stripped away from the encapsulated matter
several weeks or months after, showing a smooth inner wall, the encysting
capsule showing a decided lack of blood vessels, proving histologically
its relation to the structure of cicatricial formation.
In this Eckstein is undoubtedly mistaken. He objects to the ultimate
replacement with connective tissue for the vaselin process of Gersuny,
when in reality we have begun to realize that such result will follow any
hydrocarbon subcutaneous injection unless the latter be made in small
quantity into parts of the body which are in constant motion.
The latter is shown with injections of paraffin made into or about the
nasolabial fold. The tumor is so small as to be hardly felt by the
palpating finger, but soon takes on larger proportions, evidencing an
encapsulation of some extent or less independent of the encysted mass.
That this is true can be ascertained by incising these little hard tumors
when the contents can be readily pressed out or evacuated, the mass
appearing practically as injected months before.
The same result is shown by Harmon Smith, who made an injection of
paraffin (110° F.) into the peritoneal cavity of a rabbit which was
killed twenty-two days later. On examination no sign of inflammation of
the peritoneum was found—a fact that seems to prove the nontoxic effect
of paraffin—nor were there evidences of the formation of adhesions. The
mass had become rounded, had traveled about the abdominal cavity, and was
found lodged between the liver and the diaphragm.
Public-domain text, read in full here on John Shaqi.
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