Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
=d. Heterodermic Skin-grafting.=—In this mode of skin-grafting the
pieces of skin are taken from freshly amputated limbs of one patient or
from any selected part of the body of the newly dead, and placed upon
the defects to be covered in another patient. These grafts have been
successfully employed even after ninety-six hours had elapsed between
the time of amputation or the death of a person and the taking of the
skin-grafts.
The method employed is as follows: The site of the amputated member or
dead body from which the skin is to be taken is thoroughly cleansed, as
in the Thiersch method. Pieces of the skin, including the subcutaneous
tissue, but no fat, are cut from the cleansed parts. These sections are
cut into smaller pieces, about one inch square (_Hartman_ and _Weirick_),
and placed upon the granulating surface to be covered, leaving
one-half-inch wide interval between each piece.
The grafts are then covered with overlapping narrow strips of rubber
tissue, over which a normal saline dressing is applied. The outer
dressing is composed of gauze saturated with the same solution. These
dressings are changed every twenty-four hours.
The grafts will soon be found to adhere, showing a pinkish color in about
six days; those showing a tendency to undergo gangrene or a laziness of
attachment at this time are removed.
In about two weeks the epitheliar surfaces of these grafts are thrown
off, as with other grafts already mentioned, and shortly thereafter a
new, deep-pink epithelium is formed, the ends of the grafts throw out
epitheliar cells, which soon coalesce with those of the neighboring
grafts, eventually taking on the normal appearance and vitality of skin.
_3. Zoödermic Skin-grafting_
The advantage of using zoödermic grafts is that the patient is saved the
ordeal of general anesthesia and the secondary wound occasioned by the
removal of the graft, which necessarily leaves more or less of a scar.
The grafts for this purpose may be taken from freshly killed animals,
such as dogs, rabbits, frogs, kittens, etc.
The best results, in the estimation of the author, are obtained by the
use of the skin taken from the abdominal region of dogs.
The method for preparing these grafts is to kill a healthy animal,
thoroughly cleansing the skin of the abdomen, as already described in the
taking of any graft.
The entire abdominal surface is neatly shaved under antiseptic
precautions and the skin is dissected off in one piece, leaving the
subcutaneous tissue. It is then placed in a warm boric-acid solution and
cut into small pieces, say one or two inches square, according to the
size of the defect to be covered.
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