Buchanan County bulletin. [volume] (Independence, Iowa) 1869-1891, 1873-01-03
Skin Grating.

M. Graham to furnish us for publ
cation history Of the treatment in
the case Of Mrs. Sanford, so terribly
burned by the overturning of kerr
osenc lamp, about year since.
The case is doubly interesting from
the perfect success ofthe new pro-
cess of skin-grafting, which was
adopted to facilitate the healing of
the large surfaces burned. The fol-
lowing is DIR. Graham's response:
INDEPENDENCE, Dec 30th, 1872
Mr. EDITOR At your request, have
prepared review of the case of Mrs
Nj. IL. Sanford, who was SO horribly
burned on the goth of February, 1872. |
The BULLETIN Of that date contained a
full account of the accident, and it has
since. from time to time informed its
readers OF the slow but steady progress
OF the case, and therefore it will only be
necessary for me to recapitulatc, in the
briefest possible manner the main fea.
lures OF the occurrence. 1t will be re-
membered that Mrs Sanford was burned
while trying to save her child, whose
clothing had been set on fire by the ex-
plosion of a kerosene lamp was at
the scene within five minutes, ard, at
glance, perceived the seriousness of the
| accident. At my request for counsel and
assistance, Mrs. S. suggested DR.. Warnc,
who was Immediately sent for. and
during the twelve days that he was con-
nected with the case, he rendered mate
rial aid by his experience and skill
The child was literally burned all
over, and died within SO hours. The
extent and depth of the mothers burns
seemed to preclude all hopes of recov-
cry and, indeed, it was months before
she could be pronounced out OF, danger.
The Aggregate extent of the burns, upon
rough estimate, was at least five and
half square feet or nearly eight hundred
square inches, and covered the follow
ing parts: the whole of left hand and
arm, to shoulder; left leg, from hip to
ankle; right knee, and inside of right
thigh; right hand and arm, below ell
bow-all burned deep; lower part Of
face and front of neck; inside of right
arm, above elbow, and several places
upon her body-burncd more or less su-
perticially The constitutional effect of
SO large burn was to depress the vital i
energies and in her case it did SO to
such an extent that it was only by the
most assiduous care and attention that
her life was saved.
TREATMENT.
AS my connection with the case cx-
tended over a space of niGe months and
a half, | do not propose to go into de
tailed account of the treatment during
thr whole of that time, but shall only
give those points that will be of interest
to the general reader The application
first made and the one should advise
in almost every case Of superficial burn
ing, was carbolic acid and glycerinc q
to 81, applied by saturating cotton wool
and lightly covering the burns with It,
This was the only dressing used in the
case of Mrs. Mcbride, who was so terri
bly, burned some two years since. Blu:
many of Mrs. Sanford's wounds were
very decp-sloughed extensively, and
healed only very slowly by granulation,
SO that it was found necessary to substi-
tute CREASED rags for the more irritating
carbolic acid dressings. Later, again
used stimulation, but in different form
On the 27th of March, nearly one
month after the accident, but as soon as
the condition of the patient would per-
mit-assistcd by Dr.. Hobbic, who ad
ministered the chlorCform-I amputated
the little and ring fingers of the left
hand. She bore the operation as we'll |
as could be expected. But the most in
teresting part of the treatment was the
SKIN GRATING.
1t is q well-known fact IN medicine |
that all wounds through the true skin |
first fill up with granulations to the |
level of the surrounding skin, and then |
heal over from the edges. Now the |
skin has power to throw out granula- |
tions, or make new skin, only to a GER
tain distance, which is the reason why |
any sore OF wound, beyond certain |
size, heals so slowly, or not at all. Sci! |
ence, of late, has taught us to assist Ma |
ture, by bridging over this chasm, rs it |
were. |
Plastic operations-which are nothing |
more nor less than the dlssecting up OF |
strips of sound skin, leaving one end at
tached, and swinging the other eXtrem- |
ity around so as to cover II wound OF sore !
have been performed for many years;
but the grating, or transplanting OF
skin from one person to another, or from |
one part to another of the same person.
free from all attachment, is an advance.
mcnt in science of very recent date.
For two months or more Mrs. San.
fo-d's wounds made very considerable |
progress-some of the more superficial |
ones completely healing over in that
time but beyond this point the healing
was less rapid, and finally the work OF
PREPARATION ceased entirely Now came
choice of two or three eXpedients: to
wait for Nature to do the work, if she
would; to perform the old-fashioncd
plastic operation of making new wounds |
to heal the old ones; or to try the new
method of skin grating. | chose the
last, and l have nothing to regret 50
doing, for l firmly believe that Mrs.
Sanford owes her present state of health, |
and ability to 60 East, to our choice at
that time.
The first trial WAS made with skin
taken from the arm of her husband,
Capt. Sanford. Two pieces, the size OF
split peas, were carefully excised, placed
upon the granulating surface of the left |
knee ana shin, and firmly secured there
by means of adhesive straps. From too
much care and want of experience on
our part, they both failed to live For
good reasons. l did no more grating for
several weeks, the burns healing little,
if any, during this time.
On the 23d of July | commeisecd
transplanting again, by taking piece,
rather larger than the first ones, from
the outside of my own arm, just below
the elbow, and inserted it in the back of
Mrs Sanford's left hand. This graft
lived and grew apacc. Soon after signs
Of life appeared in it the surrounding
sore gave evidence of healthier state
the nearest skin began to make ont to
the graft, and finally connected it with
the sound flesh by a sort of isthmus,
which daily grew wider. This con
tinucd until the graft was surrounded
and lost in the new skin. The general
progress and effect of all the gratis that
lived was essentially like the one just
described. About thirty gratis in all,
from persons of all ages and both sexes:
were inserted at different times. AS far
as observed, neither age nor sex made
any perceptible difference in the living
or growth of the CRAFTS. OF course |
was careful not to take them from either
scrofulous or otherwise unhealthy per-
sons.
To get a graft / pinch up the skin,