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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