The increasing number of successful flap operations without a pedicle, induces me to report a case and to urge its more general adoption in cases of extensive cicatricial ectropion.
Geo. Davis, negro, æt. 32, came under observation at the Louisville City Hospital. Six months previously he was blown up by the premature explosion of a blast. The skin of the right side of the face and head was extensively destroyed. The angle of the mouth, ala of the nose, and the forehead were involved in dense cicatricial tissue. The lower lid was entirely destroyed. The upper lid was everted and firmly fixed to the supra-orbital margin. The free border of the lid was well preserved and contained normal cilia; the eyeball was free from injury, but showed conjunctivitis and superficial corneal erosions from exposure. From the amount of cicatrix on the face, a gliding or pedicle flap seemed impossible. The