The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
The whole method of skin grafting is based on the fact that if
epithelium be removed from any portion of the body and planted on
favorable soil elsewhere it will take root and grow, reproducing only
itself and no other kind of tissue. It is closely analogous to sewing
seed upon a favorable soil, or even to sodding. Furthermore it is not
necessary that epithelium be furnished from the individual upon whom
it is to be implanted; it may come from another of the same species or
even from a different species. Thus the skin of the frog has been used
for grafting upon human beings, and even the lining membrane of the
egg. Nor is it necessary that the epithelial cells should be apparently
alive when thus employed. Very thin shavings of human skin which have
been dried, or have been kept from decomposing by some antiseptic,
have been successfully used; nevertheless the ideal method consists in
taking what is needed from the individual who needs it.
The term skin grafting is now applied to the employment of very thin
layers of the epidermis, _i. e._, as thin as can be shaved off with a
sharp razor, and it does not apply to the autoplastic methods of skin
transplantation.
Hamilton, of Buffalo, and Reverdin, of Geneva, a number of years ago
independently discovered that minute particles of healthy skin might
be implanted upon healthy granulations and that from such minute
grafts epithelium would be produced and a fresh epidermal covering be
afforded. This method was in use for years and was a great advance on
what had previously been done. Then Hamilton, of Edinburgh, suggested
the use of thin slices of clean sponge, in order that thereby a trellis
might be offered for the growing and climbing granulation tissue; this
served a good purpose in many cavities. But the greatest advance came
when Thiersch demonstrated that large areas might be covered with skin
shavings, and that thus in a few days there would be accomplished
that which took weeks or months by older methods. His original plan
comprehended only the use of these grafts upon granulation tissue;
later it was found that they might be applied to fresh raw tissue, even
to denuded bone. Thus originated the so-called _Thiersch method of skin
grafting_.
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