Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
The skin of the frog has successfully been implanted upon granulating
surfaces by Baratoux and Dobousquet-Laborderie. They observed that the
peculiar pigmented mottling of the skin disappeared about the tenth day,
and that the grafts gradually took on the appearance of human skin
thereafter.
The best results in this method are obtained with the skin taken from the
back of the frog in preference to that of the belly or legs. This skin is
cut into pieces about one fourth inch square, which are placed upon the
granulating surface in rows, each graft being separate from its neighbor
by a space of half an inch.
At the end of forty-eight hours the plaques of skin will have adhered to
the granulating surface. At the end of five days they lose their original
color and send out cells of epithelium to each neighboring square.
The dressing to be applied over the flaps should consist of borated
vaselin, one dram to the ounce, which is smeared upon strips of sterile
gauze, over which loose gauze is placed, held in place by a roller
bandage.
The skin, once organized, is very thin, as a rule, and requires more or
less care for some time after.
_General Remarks_
The skin of the grafted area will always present a different appearance
from that of the healthy skin, both as to color, which is always paler,
and in texture. The grafted portion is usually slightly elevated above
the healthy skin, giving it an edematous look.
It has been found that skin grafts taken from the negro take more
successfully than those from the white race. White skin flaps placed upon
the negro do not meet with much success. In this event, however, the
newly grafted skin soon takes on the color peculiar to the negro and vice
versa (Thiersch).
The investigations of Karg seem to show that the pigmentation of skin is
not secreted in the rete, but is carried to it by wandering cells arising
from the deeper layer. Von Altmann has discovered certain cell granules,
termed by him bioblasts, which he believes are responsible for the
production of the pigmentary deposits under peculiar influences of the
blood.
MUCOUS-MEMBRANE-GRAFTING
The grafting of mucous membrane, both from the animal and man, has been
accomplished by Wölfler. His methods are particularly applicable to the
restoration of the conjunctiva, mucous membrane of the cheek, etc. Under
certain circumstances pedunculated skin flaps have been folded inward to
serve as the mucous membrane by Gersuny. When mucous-membrane flaps were
taken from the animal, the conjunctiva of the rabbit has been preferred.
Under peculiar circumstances, though rarely, mucous-membrane flaps may be
utilized to cover denuded skin areas. The mucous membrane, in such cases,
in about ten days takes on the appearance of the skin.
Public-domain text, read in full here on John Shaqi.
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