Materia medica, therapeutics, hygiene.

Date:
[1875?]
Catalogue details

Licence: Public Domain Mark

Credit: Materia medica, therapeutics, hygiene. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    MATERIA THERAPEUTICS, HYGIENE. 385 \,,\ — ♦ MATERIA MEDICA, TftERAPEUTf^, HYGIENE. The operation of skTtMau-itftjhk**&vs Dr. R. J. Levis, of the Pennsylvania Hospital, is now conclusively accepted as one of the resources of surgery. The utility of the transplantation of minute pieces of skin to granulating surfaces has been demonstrated in a vast number of instances. It is admitted that, by creat- ing centres of eccentric cicatrization on extensively ulce- rated surfaces, the rapidity of the healing process can be much increased. Ulcers of a chronic character, which have obstinately resisted cicatrization in a concentric di- rection, can be healed by the ingrafting of new centres of germination in the midst of the areas of ulceration. Ex- perience has also shown that the procedure is applicable to plastic surgery in facilitating the cicatrization of surfa- ces denuded by gaping in the division of cicatrices, and in the sliding of flaps of integument. Besides the increase in the rapidity of healing, due to extending the lines of cicatrizing edges, a decided and im- portant physiological influence is exerted by the presence of the grafts on ulcerated surfaces. The surface of an indo- lent ulcer seems to be stimulated to renewed vital action,' and the increased healing impulse even influences to ac- tive germination the peripheral limits of an ulcer in which granulation has long entirely ceased. The utility of skin grafting has, in my observation, been in no instances more demonstratively shown than in cases of extensive denudation caused by destruction of skin, as in burns, and loss of large areas of integument from trauma- tic injuries. In the case of a man whose back was extensive- ly charred at a lime kiln, while lying under the toxic influ- ence of its emanations, the sloughing integument having left an immense area of ulceration over his dorsal and lum- bar regions, the successful ingrafting of numerous minute pieces of skin healed the vast ulcer with astonishing rapid- ity. In an instance of the entire loss of the skin of a leg, caused by deeply burning with coal oil, which had filled a shoe and saturated a stocking, the healing process was by the same procedure rendered as surprising and satis- factory. It seems now probable that amputation, which, as a final resource, is by surgical authority justified in certain cases of extensive ulcers of the leg which all expedients