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Joseph of Berlin, father of modern nasal plastic surgery, did not use a cast after rhinoplastic operations. In fact, he was in the habit of dressing the nose with but a few thin pads of gauze gently kept in place with adhesive tapes. In order to protect the undermined and traumatized skin from necrosis through pressure, he insisted on the dressing's being light wie ein Hauch (as a breath).
For a number of years I employed this technic with satisfaction. There was one circumstance, though, which made me consider the application of pressure, namely, occasional hematoma formation beneath the undermined skin. Usually the hematoma was absorbed without ill effect. Sometimes, however, it proved to be a hotbed of infection. The nasal cavities can never be rendered completely aseptic, and disintegrating blood is a good culture medium for infection. In an effort to eliminate this hazard, the only solution was found
AUFRICHT G. DENTAL MOLDING COMPOUND CAST AND ADHESIVE STRAPPING IN RHINOPLASTIC SURGICAL PROCEDURE. Arch Otolaryngol. 1940;32(2):333–338. doi:10.1001/archotol.1940.00660020336010
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