File:The breast- its anomalies, its diseases, and their treatment (1917) (14570417369).jpg

Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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manneras to divide the subcutaneous tissue or the para-mammary fat at least 2 inches further out than the skinhas been cut, which will practically take it up near the clavicle superiorly, well beyond the sternuminternalh, below the border of the great pectoral inferiorly, or well on to the external oblique andrectus. . . . Such extensive undermining of the skin not only removes any outlying portion of the mammarygland, but facilitates the removal of the fascia covering the opposite pectoral muscle internally, that ofthe rectus and the external oblique inferiorly, and that of the latissimus dorsi externally. Undermining also insures appro.ximation of a very large wound. . . . Over the chest theintercostal muscles are exposed; inferiorly the external oblique and rectus; posteriorly the latissimusdorsi, teres major, and subscapularis, and the long subscapular nerve; at the outer aspect of the chest(the inner aspect of the axilla) the digitations of the serratus magnus and nerve of Bell.
Text Appearing After Image:
-Illustrating the Rodman operation for mammary carcinoma,serve the extensive undermining anteriorly. Second skin incision. Ob- Sternal parts of the pectorahs major and minor muscles are left at their origin to prevent adher-ence to the ribs and to make a good bed for grafting should it be required. • In tumors of the upper hemisphere the incision should be made above the clavicle and the posteriortriangle of the neck explored. In tumors of the lower hemisphere, I never e.xplore the neck. Thesupra-clavicular incision is also made in case I encounter infection of the glands or fat in Mohrenheimsspace. If the glands just belo-w the clavicle are involved, it is reasonable to infer that those just aboveit may be infected; at least it is unwise to infer that they are not. The closing of the wound is begun where it was started—that is near the clavicle, and can be ac-complished by either interrupted or continuous suture. In case of difficulty in approximating the flapsthe central third o

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