Skin grafting in severe burns

Abstract

1. 1. An experience with 203 thin skin grafts and 278 thick skin grafts used for the purpose of alleviating the damage caused by a severe burn is alluded to briefly. 2. 2. Insistence on early resurfacing of granulating surfaces caused by burns is stressed because of the marked decrease in the period of convalescence and also because of the extent to which the functional incapacitation from contractures and cosmetic blemishes can be alleviated. 3. 3. Stress should be laid upon fundamental principles and methods of skin grafting in contradistinction to the use of unusual types of grafts with or without a “far-fetched” method of placement, puncturing or dressing, as we believe these fundamental methods practically always tend to real success. 4. 4. The general principles of resurfacing an unhealed granulating surface can be discussed under the heading of the relationship of area and depth to the amount of contractural deformity; the preparation of the granulating surface for resurfacing, factors which promote reëpithelization and the type of graft preferable. 5. 5. The factors which are responsible for a healed cicatricial contracture should be stressed. The technique of correction of healed contractures must be emphasized. The average amount of final contracture of the grafted area, the chances of a good “take” and the various types of grafts preferable for certain locations influence one in the selection of the type of graft to be used. 6. 6. The use of “calibrated grafts” seems to herald a definite step forward in the art of skin grafting and the final results obtained by their use are considerably better than those obtained previously.