SURGERY OF THE BAR 189 



consist of blood or serum, clots, and tissue debris. 

 The cavity between the skin and cartilage is then 

 gently but thoroughly curretted and any hemorrhage 

 controlled by pressure. The next step is to suture 

 the wound and completely obliterate the cavity be- 

 tween the skin and cartilage. 



Method of Suturing. — The needle is introduced 

 from the opposite side of the ear flap through the 

 skin and cartilage so that it comes through about 

 one eighth of an inch from the edge of the wound. 

 The suture is taken across the wound and up 

 through th^ flap again, and tied. The sutures must 

 be placed about one eighth of an inch apart and be 

 of sufificient number to completely close the wound. 



Additional sutures placed in the same manner are 

 then put in where required to obliterate the cavity 

 and insure close approximation of the skin and carti- 

 lage. The ear is then swabbed with ether, the 

 wound sealed with iodized collodion, and the whole 

 ear enveloped in a sterile gauze and wool dressing, 

 laid on the top of the head, and the ear cap or many- 

 tailed bandage applied. 



The position of the ear should be changed every 

 twenty-four hours ; that is, bandaged over the top 

 Df the head or against the cheek. The dressings 

 should be removed on the fourth day and the wound 

 examined. As a rule, with good technic healing is 

 by first intention, but if not the ear is cleaned every 

 lay with hydrogen peroxid and dressed with anti- 

 septic dusting powders and dressings, gauze and 

 wool, until healed. The sutures are removed on the 

 seventh day. 



Plastic Operation for Split Ears 



Split or torn ear flaps are commonly the result of 

 lighting, and unless remedied give the patient a 



