Pinch Grafts Research Articles

Ｐｉｎｃｈ Ｇｒａｆｔの中耳炎手術（Ｏｐｅｎ Ｍｅｔｈｏｄ）への応用

To shorten the hospital stay, a secondary skin graft was applied to the operated mastoid cavities made by the open method of tympanoplasty or by radical mastoidectomy.Pinch grafts (small islands of the epidermal layer) were transplanted on an average of 28 days after the operations, soon after the mastoid cavities were covered with healthy granulation tissue. In 8 of the 10 patients treated, the grafts took well, and complete healing was established on an average of 11.1 days after the grafting operation. The procedure reduced the length of hospitalization more than 2 weeks. We are convinced that the pinch graft was beneficial for mastoid cavities made by the open method of tympanoplasty or by radical mastoidectomy.

Skin Grafting as an Office Procedure in Dermatology

The author describes the use of full-thickness, split-thickness, and pinch skin grafts by the dermatologist in the office (or hospital). The techniques stress simple, proved methods by which the beginner can teach himself. Biologic considerations are described. The results, complications, and indications are emphasized, with particular reference to the use of skin grafts in place of skin flaps.

Surgical gem. An alternate method of obtaining a pinch graft.

The Journal of Dermatologic Surgery and OncologyVolume 8, Issue 3 p. 162-162 Surgical Gem: An Alternate Method of Obtaining a Pinch Graft JUNE K. ROBINSON M.D., JUNE K. ROBINSON M.D. Dr. Robinson is Assistant Professor of Dermatology and Surgery, Northwestern University, Chicago, Illinois.Search for more papers by this author JUNE K. ROBINSON M.D., JUNE K. ROBINSON M.D. Dr. Robinson is Assistant Professor of Dermatology and Surgery, Northwestern University, Chicago, Illinois.Search for more papers by this author First published: March 1982 https://doi.org/10.1111/j.1524-4725.1982.tb00255.xCitations: 4 Reprints are not available. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume8, Issue3March 1982Pages 162-162 RelatedInformation

Pinch grafts in the treatment of chronic venous leg ulcers

Pinch grafts in the treatment of chronic venous leg ulcers

Chronic leg ulcers treated by the pinch graft method

Forty-nine patients with chronic leg ulcers were treated by pinch grafting. The initial success of this procedure was high for both gravitational and arterio-sclerotic ulcers. Over half the grafted gravitational ulcers and 70% of grafted arteriosclerotic ulcers were intact after 2 years. Some grafts remained stable for 6 years. Arteritic ulcers did not respond as well; none of the grafted ulcers survived more than 6 months. Pinch grafting is still a simple, cheap and effective therapy offering prolonged graft stability as well as quicker healing to those patients who are not fit for more extensive surgery.

Pinch Grafting for Chronic Ulcers on Lower Extremities

Chronic ulceration of the skin of the lower extremities continues to be a difficult therapeutic problem. Pinch grafting of ulcers of the legs from a variety of causes, has proved to be highly successful. The success rate and complications of this procedure performed in the Department of Dermatology at the University of Iowa over a five-year period (1971-1975) are reviewed. The basic technique and pre-operative and post-operative care are outlined. Management of difficult cases by using such techniques as the Jobst pump, heterograft skin dressings, and sublesional steroid injection is also discussed.

Pinch grafts in the treatment of chronic venous leg ulcers

130 patients with 170 chronic recurrent venous ulcers of the leg treated with pinch grafts following elimination of underlying venous disease are presented. Pinch grafts, when used by the method described, form a soft, pliable and highly resistant skin cover which withstands the stresses of daily life.

Monographs on Plastic Surgery: The Use of Skin Grafts

The author has intended his book "for general and orthopaedic surgeons overseas who from time to time are called upon to perform plastic surgery operations." With that readership in mind, he has described techniques that "... are not the latest or the most sophisticated, but all have been found to be effective and reliable." The book begins with a one-page history of grafting followed by an excellent discussion of the various types of skin autografts, their advantages and disadvantages. This reviewer appreciated the advice against pinch grafts because "the method is slow, tedious, and the final result unsightly..." as is the donor area. Not mentioned is the fact that a pinch graft is usually a full-thickness one, if taken by a scalpel from skin raised by a needle. Mr. Bell's remarks about the methods and sites of procuring and immobilizing skin grafts are sound and clearly presented. Somewhere a strong plea

Pinch grafts for cutaneous ulcers.

Pinch grafts for cutaneous ulcers.

A TECHNIQUE FOR INCREASING SKIN AUTOGRAFT COVERAGE.

IN FULL thickness burns involving more than 30% of the body surface, the available donor sites are often inadequate to provide the required split thickness skin to cover the defect. It is desirable to increase potential coverage from limited donor sites without decreasing the physiologic effectiveness of the skin grafts. A new technique of expanding grafts by making slits in the skin has been successfully used. Present techniques include<i>split thickness grafts in sheets</i>that cover an area on the recipient site equal to the donor site. This method provides the most effective skin replacement, but is only effective in smaller burns.<i>Pinch grafts</i>increase the area covered from an available donor site, but the new skin surface provided is poor and often requires regrafting. This method is also inadequate for large burns as it is difficult to manage the small grafts on the recipient site.<i>Postage stamp grafts</i>can

CHRONIC LEG ULCERS.

IN THE DISCUSSION to follow there may be few, if any, original concepts developed. However, it will be my object to present a working classification of chronic leg ulcers, to outline a plan to establish the proper diagnosis, and to suggest a logical approach to successful management. Among the treatment procedures discussed, emphasis will be placed on the use of pinch grafts by the dermatologist to hasten the involution of large recalcitrant leg ulcers. Classification will reflect the combined experience of many clinicians. A detailed differential diagnosis and clinical description of each entity would require an extensive monograph, which is outside the scope of this presentation. Also, certain conditions which affect the feet predominantly, such as diabetic gangrene and so-called neurotropic ulcers, will not be considered. Only ulcerations which predominantly affect the legs will be included. Any classification of ulcerations of the leg must be arbitrary, and this will

Open skin grafting.

Open skin grafting, or the application of split-thickness skin grafts without a covering dressing, is not a new technique, but is one which has not received the attention or acceptance that it deserves. A search of the Quarterly Cumulative Index Medicus for the years 1916-1958 disclosed only 8 reports in the English language devoted primarily to the open method of grafting. 5-7,12,13,20,22,23 It is the purpose of this paper to review briefly the history of the development of this technique, to describe its use, and to discuss its merits, as judged by a 5-year experience with the method. According to Koch, 14 when Reverdin presented his paper in 1896 describing the first successful free skin transplant he stated that after applying the pinch grafts he held them in place with a Diachylon Dressing. So far as could be determined in this review, no one questioned the need for a pressure

The Sex-Linked Histocompatibility Antigens

Sex-linked histocompatibility antigens were studied in 6 strains of mice. Fitted pinch skin grafts taken from the dorsal or lateral side of the body were made in such a way that hair growth on the graft would be in a direction opposite to that of the recipient. 2nd-set grafts were made 42-80 days after the 1st graft. To determine the immunizing effects of various tissues the spleen lymph nodes and liver were inoculated intraperitoneally from males to females. The production of the H-2 antibody was examined in females immunized with male tissue using the dextran-human serum method. Male-to -female skin grafts were rejected 100% in all 6 strains of mice tested whereas skin grafts involving other sex combinations were successful. Male-to-female grafts were rejected even after the growth of new hair. The immunological nature of the graft rejection was confirmed by the existence of a 2nd-set response in all the strains. The presence of sex-linked histoco mpatibility antigens seemed to be a general phenomenon. In addition to skin the antigens were present in other tissues such as liver and spleen. Sex-linked antigens in relation to the H-2 system seem to be weaker antigens like H-3 and H-1 do not elicit the production of detectable hemagglutinins and do not appear to elicit the type of cytot oxic antibodies that are detected by the addition of complement. It is suggested that the antigenic differences between male and female tissues could be used to separate sperm carrying the X from the sperm carrying the Y chromosome.

Some interesting aspects of burn therapy

1. 1. Intravenous therapy in combating the shock phase of the severely burned patient can be governed as to time and quantity given by blood pressure and pulse readings alone. 2. 2. Quantities of fluids given (especially plasma) exceeded the usually recommended amounts considerably without causing ill effects. 3. 3. Neo-synephrine laryngeal spray may be of great value in handling laryngeal edema. 4. 4. The almost forgotten technic of pinch grafting may be of value in the severely burned patient in whom general anesthesia is a hazard and in whom there is a deficiency of donor area in relation to a much larger recipient area. 5. 5. Close attention to forced protein feedings, vitamins and repeated whole blood transfusions are essential to maintaining the patient and getting grafts to take in the epithelialization phase of burn therapy.

Gas gangrene of the perineum

Two cases are reported in which patients suffered with gas bacillus infection originating in the perianal fossa and extending to involve the scrotum, genitalia, perineum, inguinal canals and thighs. In one patient incision and drainage was followed by staged debridement and then by epithelization with aid of flap and pinch grafts. In the other patient primary débridement was accomplished followed by secondary closure using pedicle flap and split-thickness grafts. Antibiotics and antiserums were used in addition to surgical cleansing of the involved areas. Both patients recovered.

PINCH GRAFT

PINCH GRAFT

Healing of Tuberculous Pulmonary Cavities by Means of Skin Grafts

Giant tuberculous pulmonary cavities continue to present one of the most complex problems in the surgical treatment of pulmonary tuberculosis. Various types of collapse therapy have resulted in a high percentage of failures. Intracavitary drainage in tension or blocked cavities, combined with collapse therapy, has greatly increased the number of good results. Intracavitary drainage without collapse therapy provides relief from toxicity but is of little value in cavity closure. In advanced pulmonary disease with multiple cavitation, collapse therapy is contraindicated. We wish to present a somewhat different point of view. Let us consider that a tuberculous pulmonary cavity is a chronic lung abscess: The lung surrounding a chronic nonspecific lung abscess shows little disease. When such an abscess is drained, the surrounding lung tissues fill in the defect occupied by the abscess. In a tuberculous lung abscess, the surrounding lung tissues are usually diseased and cannot expand to fill in the space occupied by the abscess cavity. Drainage is of cleansing value in pulmonary tuberculous cavities, as in other types of pulmonary abscesses, but cavity obliteration does not occur without collapse therapy. At the Grace Dart Home Hospital large cavities have been treated by intracaavitary drainage. The residual cavity space has been opened into by cavernostomy, carried out through the sinus tract of the drainage tube. The exposed cavity walls and floor have been covered with split-thickness skin grafts or pinch grafts. Gradually the boundaries of the cavity are lined with skin which grows out to meet the skin on the surface of the chest wall. The cavity thus becomes obliterated, leaving a defect in the chest wall. The first case selected was a 5 2-year-old male with far-advanced bilateral pulmonary disease with giant bilateral apical cavities.

SENSITIVITY TO FURACIN

To the Editor:— The paper entitled Use of 5-Nitro-2-Furaldehyde Semicarbazone in Dermatology (The Journal, February 1) aroused great interest here, especially in view of our unfortunate first experience with Furacin Soluble Dressing. The patient was a white man who had no known allergy and who had never exhibited any skin sensitivity. He had sustained a fracture of the calcaneus several months previously. An area of pressure necrosis about the medial malleolus had developed from the cast, and the resulting infected ulcer was extremely slow to heal, little improvement having been obtained from local penicillin. Furacin dressings had finally been used, and a clean granulating base, suitable for grafting, had developed in ten days. The pinch grafts yielded approximately a 50 per cent take, Furacin having been used on all dressings subsequent to grafting. At this point, in September 1946, the patient was consigned to care at this activity with the

PENICILLIN FOR ULCERS OF LEG TREATED BY PINCH GRAFTS

Ulcers of the leg are a perennial problem in charity hospitals because of their slowness in healing and consequent long periods of bed occupancy. For many years pinch skin grafts have been used in the dermatology service for most ulcers larger than 5 cm. in diameter because of the shortened time of hospitalization required and because the grafted area is better than the scar which results from normal healing. In 1943 Ringrose 1 reported the results obtained with this type of graft in 29 cases treated here up to that time. The outcome was good to excellent in 80 per cent, but there was an incidence of 10.3 per cent of complete failure. The cause of failure did not become evident for some time. Culture of the ulcers on admission, which at first was done sporadically but later became routine, indicated that the type of organism in the ulcer was

Refrigeration Anesthesia in Skin Grafting

Refrigeration anesthesia for skin grafting opens a new field for the use of reduced temperatures in surgery. In 27 cases requiring small or multiple small split thickness skin grafts this method was used. Pinch grafts could be removed equally well, although none were attempted in this series. Results were so satisfactory that this report is submitted for general consideration. In July 1941 my associates and I began to use refrigeration anesthesia for the amputation of extremities. When an extremity is refrigerated for amputation, a tourniquet is always used. Ordinarily the constriction of a tourniquet is painful. Some of the original workers in refrigeration anesthesia discovered that previous chilling of the tissues with ice bags definitely decreased this discomfort. We corroborated this finding, noting also that the skin was completely anesthetized. It was this ability of ice bags to produce superficial anesthesia that led us to attempt the method on donor