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Updated: June 18, 2025
There are certain details making for success that merit attention: the graft must not be roughly handled or allowed to dry, or be subjected to chemical irritation; it must be brought into accurate contact with the new soil, no blood-clot intervening between the two, no movement of the one upon the other should be possible and all infection must be excluded; it will be observed that these are exactly the same conditions that permit of the primary healing of wounds, with which of course the healing of grafts is exactly comparable.
If my theory is correct, I do not suppose they would have found anything in the contents of the thorax or the abdomen, but it is just possible that analysis of the matter removed from the cranial cavity might have revealed a small blood-clot in the brain." The Captain twitched up his eyebrows and stared at him in open-mouthed amazement. "Of all the By Jove! you know, this beats me!
Healing is more rapid when the edges are in contact, when there is a minimum amount of blood-clot between them, when the patient is in normal health and the vitality of the tissues has not been impaired. Wounds heal slightly more quickly in the young than in the old, although the difference is so small that it can only be demonstrated by the most careful observations.
If the wound is closed, the narrow space between its edges is occupied by blood-clot, which consists of red and white corpuscles mixed with a quantity of fibrin, and this forms a temporary uniting medium between the divided surfaces. During the first twelve hours, the minute vessels in the vicinity of the wound dilate, and from them lymph exudes and leucocytes migrate into the tissues.
On opening the pericardium it was found to be filled with blood-clot, and on washing this away a laceration about 1 1/2 inches in length was found in the left ventricle; the aperture was closed by a recent clot. The cavities of the heart were dilated, the walls thin and in advanced stage of fatty degeneration. There was no valvular disease. The aorta and its main branches were atheromatous.
Death of skin is more liable to occur in bleeders, and when the slough separates the blood-clot is exposed and the reparative changes go on extremely slowly. Suppuration may occur and lead to the formation of an abscess as a result of direct infection from the skin or through the circulation. Treatment.
The meshes are filled in by growing tissue, and as it grows the tissue absorbs part of the sponge, which is itself an animal tissue and acts like catgut. Part of it is also thrown off. In fact, the sponge imitates what happens naturally in the porous network of a regular blood-clot. It educates the tissue to grow, stimulates it new blood-vessels and nerves as well as flesh.
Capillary loops grow into the coagulum, and migrated leucocytes from the adjacent blood vessels destroy the red corpuscles, and are in turn disposed of by the developing fibroblasts, which by their growth and proliferation fill up the gap with young connective tissue. It will be evident that this process only differs from healing by primary union in the amount of blood-clot that is present.
On the inner lining of the coat there was a dark stain around the slit, though the immersion in the river had of course washed away any definite blood-clot. Lars Larssen nodded appreciation of the young fellow's method of going straight to the heart of the subject. "Good!" said he. "Now for details." "I carried out your orders exactly, sir.
The presence of a metallic foreign body having been determined and its position localised by means of the X-rays, all devitalised and contaminated tissue is excised, the foreign material, e.g., a missile, fragments of clothing, gravel and blood-clot, removed, the wound purified with antiseptics and closed or drained according to circumstances.
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