Plastic surgery; its principles and practice . 1234 Pig. 70.—Chronic ulcer of the groin, following the excision of tubercular (?) glands. Duration two years. 1. Note the position of the ulcer and the scar above it, as the ulcer gradually healedabove and extended below. 2. The same ulcer eight months later, after excision with the cautery. Note theposition, now on the level with the anus, healing having taken place above. 3. Ulcer on the thigh following an infection from the parent ulcer in the area from whichsmall deep grafts were removed. 4. The scar following healing of the ulcer shown in i
Plastic surgery; its principles and practice . 1234 Pig. 70.—Chronic ulcer of the groin, following the excision of tubercular (?) glands. Duration two years. 1. Note the position of the ulcer and the scar above it, as the ulcer gradually healedabove and extended below. 2. The same ulcer eight months later, after excision with the cautery. Note theposition, now on the level with the anus, healing having taken place above. 3. Ulcer on the thigh following an infection from the parent ulcer in the area from whichsmall deep grafts were removed. 4. The scar following healing of the ulcer shown in i and 2. This was finally accom-plished by frequent excisions with the cautery and numerous graftings. This photographwas taken just one year after the first picture in this group. None of the tests tried revealed the cause of the great resistance of this ulcer to treat-ment. There has been no recurrence during the six years which have elapsed since dis-charge from the Fig. 71.—Result of small deep grafting on a third-degree burn of the forearm and wristof a negro woman. The grafts can be seen in little pits surrounded by a keloid-like tendency to contracture in this situation is quite marked and a profile view showsflexion of the wrist. The advisability of using small deep grafts on an ulcer of this extentand in this situation on a negro is very questionable. any other instrument, to a granulating wound without occasionallytouching the granulations with the instrument. In order to avoid thischance of contamination, it is best either to use a fresh needle for each THE TRANSPLANTATION OF SKIN 63 graft or to have several needles, so that one can be flamed while theother is in use^ (Fig. 70). Another disagreeable occurrence is the formation of keloid. Occa-sionally a massive keloid will form in the grafted area, and the graftsthemselves can be seen at the bottom of little depressions in the keloid(Fig. 71). This growth would probably occur
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