Skin Grafting According to Thiersch's Method

Felix Franke
1889 Annals of Surgery  
Brunswick). The author's first two cases were, first, a bedsore over the tendo-achilles, and, second, an ulcer on the inner side of the thigh and outer side of knee, due to a burn. He used skin from an amputated leg to cover the defects, but had only a partial success. He attributes his failure first to want of practice, second, that the skin came from a tuberculous individual. After this he always used skin from the patient himself and found that the best place from which to remove the skin
more » ... remove the skin was on the outer side of the thigh near the great trochanter. The strips removed were often io to 12 cm. long and 4 to 5 cm. wide. He found these large strips healed thoroughly provided that all haemorrhage from the previously scraped ulcer had been completely checked. The grafts were covered with rubber tissue, over which an antiseptic dressing was applied, and this was changed on the 4th day. The author finds that transplantation of frogs skin gives no perma¬ nent result; it heals on temporarily, but later becomes either loosened or completely absorbed. He treated all cases of ulcer of the leg, in his hospital wards, by skin grafting according to Thiersch's method and is so satisfied with the results that he states that ulcers should not be treated by any other method. He details some of his more interesting cases. One, a man set. 20 years, had been suffering for two years from an ulcer on the left leg, which ulcer was situated a little below the middle of the tibia and measured xo cm. in its transverse diameter; its appearance was un¬ clean, and its centre full of exuberant granulations; the edges were hard, glazed and firmly attached to the bone. The tibia in this neigh¬ borhood was much thickened as by the formation of callus, the skin in the neighborhood was bluish brown and felt cicatricial, and was not as freely movable as on the other leg. Frog grafting was tried without result. A plastic according to Maas was undertaken, and to do this properly, a piece of bone about the size of a silver dollar had to be chiseled out of the centre of the ulcer; the flap was taken from the posterior surface of the right leg. The flap healed kindly but was so
doi:10.1097/00000658-188901000-00127 fatcat:svdctwlmdrd3xdrq7ws4xvzzbe