Thiersch Grafts Research Articles

Technic of Total Ectropion Operation

The operation here described uses Thiersch grafts applied to the raw surface exposed by freeing adhesions placing stitches in the margin of the lower lid attaching it to the region of the brow. An illustrative case was reported. Read before the Chicago Ophthalmological Society, February 15, 1926. See p. 629. The operation here described uses Thiersch grafts applied to the raw surface exposed by freeing adhesions placing stitches in the margin of the lower lid attaching it to the region of the brow. An illustrative case was reported. Read before the Chicago Ophthalmological Society, February 15, 1926. See p. 629.

Safety-Razor to Cut Thiersch Grafts

To the Editor: —Since several physicians are reporting their use of the safety-razor as a knife, I wish to report my early use of it as a section-cutter for Thiersch grafts. In this it excels Thiersch's planoconcave razor or any other instrument I ever used. To make the safety-razor practical it is best prepared by grinding about one-eighth inch off the comb or guard. Then one can cut to the right angle, and the length of the graft is limited only by the size of the part from which it is taken. I first used the safety-razor in this way Aug. 20, 1909, to graft after a scald of buttock and thigh.

DEVELOPMENTS IN THE SKIN-GRAFTING OPERTION FOR CANCER OF THE BREAST

It has been my custom every year or two to request our patients operated on for mammary cancer and living in or near Baltimore to come on certain mornings to the surgical clinic of the Johns Hopkins University in order that we may observe the ultimate result, particularly with reference to the function of the arm. For about sixteen years our practice has been to cover the fresh defect, made as small as feasible in various ways, with large Thiersch grafts. The available skin was tucked high into the armpit in order to cover the axillary vessels, to obliterate the dead space under the clavicle, and to elevate to the highest possible point the axillary fornix. The tip of the axillary flap was usually cut away. Notwithstanding this precaution a little necrosis of the badly nourished flap was not infrequently observed, and as a consequence there occurred an occasional but

AN OPERATION FOR ESTABLISHING A CUL-DE-SAC FOR THE WEARING OF AN ARTIFICIAL EYE; WITH REPORT OF CASES.

In the endeavor to establish a cul-de-sac in cases where from any cause the conjunctival sac has become reduced to such an extent that an artificial eye can not be worn, very many devices have been resorted to. Operative procedures which involve the transplanting of a flap of integument or of mucous membrane have been most numerous. Flaps of integument with a pedicle, flaps without a pedicle (Wolfe) taken from various parts of the body, Thiersch grafts, mucous membrane from the lips (Abadie), vulva 1 and prepuce (Bock) using that of an infant; heterogeneous tissue as conjunctiva from the rabbit, first employed by Wolfe 2 in 1883. Harlan 3 has devised a method of operating in which by means of a lead wire he seeks to establish a canal at a depth in the tissue corresponding to the normal location of the fornix conjunctivae. When the canal is lined with

ON THE USE OF EPITHELIAL GRAFTS FOR REPLACING THE OCULAR CONJUNCTIVA.

The unsatisfactory results obtained by the transplantation of rabbit's conjunctiva upon the eyeball, the laborious work of freeing from all shreds of submucous tissue the mucous flaps cut out with scissors or scalpels; and on the other hand, the ease with which Thiersch's skin grafts can be obtained and the certainty with which they grow in their new bed, have induced me many years ago to make use of Thiersch's grafts in operations for pterygium, symblepharon and other conditions where it was desirable to replace lost conjunctiva. The results obtained by these operations were very satisfactory; the grafts answered the purpose for which they were implanted; in many instances they became after some time as smooth and glossy as the surrounding conjunctiva; and though in other cases they continued producing a white coating of epidermis cells, I have never found this condition to cause any irritation. Still I have always

SKIN GRAFTING ON THE EYELIDS.

Skin grafts play an important role in the plastic operations upon the eyelids; they are especially serviceable in certain forms of ectropium and entropium. 1. Skin Grafting in Ectropium. —If the destruction of the integument of the eyelid has been so extensive as to result in a more or less complete ectropium, the lid can not be restored to its normal position unless it be provided with a new integument. The material for this new covering may be obtained from three sources, to-wit.: we may transplant upon the lid a skin flap from the vicinity; or we may graft upon it a piece of skin from the arm (Wolfe's method); or we may cover the whole defect with Thiersch's grafts. If executed under the proper aseptic precautions, these different plans are probably equally successful as far as the immediate healing of the implanted material is concerned. And those who are