A MODERN WONDER.

Hauraki Plains Gazette, Volume XXXVII, Issue 4996, 5 July 1926, Page 3

A MODERN WONDER.

GRAFTING OF HUMAN TISSUES.

EVEN A BEARD PLANTED. A lecture was delivered under the auspices of the Wellington branch of the British Red Cross Society by DrC. R. Chids, M. 8., F,R,E,S, on the “Transplantation or Grafting of Human Tissues, as Applied to General

Surgery.” “Tissue grafting,” said the lecturer, “is a comparatively recent development in surgery, and it is interesting to trace its history. In the pre-anti-septic and pre-aseptic days, surgeons

found, in treating accidental wounds, that damaged tissue partially deprived of its blood supply invariably sloughed and died. This' forced surgeons to be most radical in theii treatment of, wounds, .and the practise in those days was to remove damaged tissue, with the result that large open wounds, taking months to heal, were left to be treated. The reason lor the damaged tissue sloughing was found to be due to toxins, or poisons, produced by germs that came into contact with the wound at the time of .the accident. With the introduction of Lord Lister’s antiseptic methods it was found that damaged tissue, which would have previously sloughed and died, now, after being sickly for a day or two, tended to recover and finally became quite healthy. This recovery of damaged tissue wajs found to be due. to enlargement of small existing blood vessels and the actual formation of new blood vessels. With the discovery that damaged tissue could recover surgeons . changed their tactics and became more conservative in the treatment of open wounds. “Having succeeded in saving damaged tissue, the. next question presented itself to surgeons was: ‘How to replace missing .tissue.’ In 1869 Riverden experimented with skin grafting in the treatment ot open wounds. He removed small pieces of skin and placed them on open wounds and found that under asteptic conditions the skin not only bred, but grew, and finally covered .the whole wound surface. This was a really great discovery, and meant that months were sa.ved in the healing of large wounds and .that the resulting scars, instead of being weakly and always giving rise, to trouble, were firm and strong, and did not tend to break down when subjected to slight injuries. Following on Riverden’s discovery all .the different tissues in the body were experimented upon, and the. readiness with which they grafted was ascertained. ■ It was found that such tissues as skin, blood, cartilage, connective tissue, and muscle loaned themselves excellently for grafting purposes, while others, such as the thyroid gland, grafted only moderately .well, while still others, composed of highly sensitised tissues, such, as the liver,- kidneys, and nervous tissue, would not graft at all. "Bone has largely been used for grafting purposes. If, possible, when performing a bone graft, the surgeon always uses one of the. patient’s own bones 1 . Sometimes a, bone from another individual is used (i.e„ of the same species), while from time to time animal bones have been tried for grafting purposes, but it is found that they they are not satisfactory. “Roughly speaking, there are three methods used in bone grafting: (1) The ' sliding graft. This method is used in the ordinary fracture case, and consists of grooving both fragments of the fractured bone apd placing in the groove the graft which has been obtained from another bone. (2) Intramedullary peg. This, consists of fitting the graft into the hollow or middle of the broken bones, to keep them in alignment. (3) Bone pegs. Here pieces, of bone are 'removed and fashioned into pegst and are used to nail or peg together broken bonesi. “Bene grafts are used hot only in fracture cases, but also in tuberculosis disease of the spine, where a, graft from a bone, is often fixed into the spine in order to immobilise the diseased site and thus give it. a chance to heal. Bone pegs* are also used to immobilise flail joints resulting from infantile paralysis. “Cartilage, more or less resembles bone, and is largely used in the repair of fra.ctored and deformed noses and torn ears. Cartilage grafts? are usually obtained from the ribs. Fat, being poorly nourished, is not largely used for grafting, but is. sometimes used for padding purposes, while connective oi* fibrous tissue is largely us'ed, especially in hernia dr rupture repairs The fibrous tissue is usually obtained from the thigh. It is also used for making live ligatures, which are sometimes used in surgery. Nerves are used 'for bridging gaps in nerves, but the actual nervous! tissue degenerates. Still, the nerve tissue from the injured nerve grows down through the bridge and restores the function of the severed or cut nerve. If completely removed from one site to another, muscles revert to inert fibrous tissue, but if their insertions alone are transplanted .they retain their contractability and function, and this, method is largely used to replace paralysed muscle. It is with skin that the most wonderful results have been achieved. During the late war skin grafting reached a high state of perfection.” The speaker described the various methods of performing skin grafts. Either a thin shaving of tissue, not consisting of the whole thickness, of the skin, was taken and placed upon the tissue on to which it was to be grafted. (This method was still used in large grafts on .the face, when treating burns, and also l in the mouth when treating cleft palates.) Or the whole thickness of the skin was used. This method was very widely used, especially in the treating of face deFormities, such as’ those caused by burns and street accidents. Another method was the .tube graft. Here a tube of tissue was transplanted from one part of the body to another, such as from the chest to the face. It was with these tube grafts that the most wonderful operations, such as making up a new face or nose, had been peiformed.