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As soon as the ulcer assumes the characters of a healing sore, it should be covered with skin-grafts, which furnish a much better cicatrix than that which forms when the ulcer is allowed to heal without such aid.
The only satisfactory method of getting rid of the coloration is to excise the scar; the edges are brought together by sutures, or the raw surface is covered with skin-grafts according to the size of the gap. Hypertrophied Scars.
The neck-grafts were supplied by the skin of the father and brother, but the arm-grafts were taken from two young puppies of the Mexican hairless breed, whose soft, white, hairless skin seemed to offer itself for the purpose with good prospect of a successful result. The outcome was all that could be desired. The puppy-grafts took faster and proved themselves to be superior to the skin-grafts.
Bartlett, and placed on her head about two hours after the accident, but it did not stay in position. Then the head was covered twice by skin-grafts, but each time the grafts were lost; but the third time a successful grafting was performed and she was enabled to work after a period of two years.
When the ulcer has assumed the characters of a healing sore, skin-grafts may be applied to hasten cicatrisation. Ulcers in a callous condition call for treatment in three directions The infective element must be eliminated.
The most satisfactory treatment is to excise the affected tissues and fill the gap with skin-grafts. [Illustration: FIG.
In extensive ulcers resulting from recent burns, if the granulations are healthy and aseptic, skin-grafts may safely be placed on them directly. If, however, their asepticity cannot be relied upon, it is necessary to scrape away the superficial layer of the granulations, the young fibrous tissue underneath being conserved, as it is sufficiently vascular to nourish the grafts placed on it.
The first indication is to exclude bacteria by purifying the damaged part and its surroundings, and applying dry, non-irritating dressings. When these measures are successful, dry gangrene ensues. The raw surface left after the separation of the dead skin may be allowed to heal by granulation, or may be covered by skin-grafts.
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