[Anomalies and Curiosities of Medicine by George M. Gould]@TWC D-Link book
Anomalies and Curiosities of Medicine

CHAPTER XIV
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Symonds reports cases of skin-grafting of large flaps from amputated limbs, and says this method is particularly available in large hospitals where they have amputations and grafts on the same day.

Martin has shown that, after many hours of exposure in the open air at a temperature of nearly 32 degrees F., grafts could be successfully applied, but in such temperatures as 82 degrees F., exposure of from six to seven hours destroyed their vitality, so that if kept cool, the limb of a healthy individual amputated for some accident, may be utilized for grafting purposes.
Reverdin originated the procedure of epidermic grafting.

Small grafts the size of a pin-head doing quite as well as large ones.
Unfortunately but little diminution of the cicatricial contraction is effected by Reverdin's method.

Thiersch contends that healing of a granulated surface results first from a conversion of the soft, vascular granulation-papillae, by contraction of some of their elements into young connective-tissue cells, into "dry, cicatricial papillae," actually approximating the surrounding tissues, thus diminishing the area to be covered by epidermis; and, secondly, by the covering of these papillae by epidermic cells.

Thiersch therefore recommends that for the prevention of cicatricial contraction, the grafting be performed with large strips of skin.
Harte gives illustrations of a case of extensive skin-grafting on the thigh from six inches above the great trochanter well over the median line anteriorly and over the buttock.


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