On the transplantation of skin en masse in the treatment of ectropion and other deformities / by Charles Bell Taylor.

  • Taylor, Charles Bell, 1829-1909.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: On the transplantation of skin en masse in the treatment of ectropion and other deformities / by Charles Bell Taylor. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    had been removed that the eye would not close, and I deter- mined to replace it. No precautions whatever were taken, and although the flap had been separated from the body for nearly half an hour, and was apparently quite dead, the wound healed like a cut Anger. So remarkable a success made a great impression on my mind, and being unaware at the time of what had been done in this direction by Lefort and others, I came to the conclusion that I had stumbled upon a discovery of some importance, and accordingly brought the case in question, together with a child in whom I had replaced the eyelid by a flap taken from the arm, under the notice of the members of the British Medical Association at the annual meeting when held in Leicester in 1877. The accompanying photograph exhibits a very similar case to the one then presented to the notice of the meeting. It is, as is evident at a glance, a bad case of deformity, the result of ectropion, caused by extensive exfolia- tion of diseased bone in a delicate and scrofulous subject. This child, who came from a distance, had been seen by other surgeons, and some attempt had been made to remedy the deformity; but the small portion of the upper lid, which had escaped destruction, was so flrmly embedded . in the •liseased tissue that it was evident that nothing but a most careful operation with transplantation of new skin, necessarily from a distant region, would suffice, while it was clear that, unless something was done, the eye, constantly open, con- gested, and perpetually exposed to external irritation, would be seriously damaged. It was impossible to preserve a pedicle while transplanting from a distant region, as the patient was exceptionally timid and irritable. I therefore decided to transplant en masse, and selected for the purpose a piece of delicate skin from the inside of the arm. The upper lid, as may be noticed in the photograph, was turned completely inside out, and I took advantage of this position to make a raw surface well within the lashes; a similar raw surface was established on the opposing edge of the lower lid; what remained of the eyelid cut free from its deep-seated attach- ments, and the two raw surfaces brought together g,nd firmly attached by sutures deeply placed in the lids. The upper