cellular ducts, which filled it immediately with blood from the granulation vessels, and that this blood then circulated in the vessels of the applied skin. Moreover, he held, that the vessels of the transplanted skin were liable to a secondary change in which their structure approached, for a while, more or less that of the granulation vessels.
In 1886 Thiersch read the report of his perfected method of skin grafting at the Fifteenth Congress of the German Surgical Association. He showed that the healing of wounds of any size could be brought about more quickly by covering the defects with large films of epidermis together with a portion of the dermis: These films were shaved off and placed so as to entirely cover the wounds from which granulation tissue six weeks old had been removed.
The method became widely known as Thiersch grafting, no credit being given to the priority of Ollier's work. In all justice the proper title should be the Ollier-Thiersch method. These large grafts completely superseded the smaller grafts recommended by Reverdin, and his method was almost forgotten.
W. S. Halsted early in 1890 showed a case before the Johns Hopkins Hospital Medical Society in which a leg ulcer, 20.×12. cm. (8×44⁄5 inches) and of 14 years' duration, had been successfully grafted with Ollier-Thiersch grafts. He said that Thiersch scraped the ulcer and planted his grafts on the scraped and necessarily infected surface. The surface being infected, it was necessary for the dressing to be changed every day for about one week. Dr. Halsted's method was to cauterize the ulcer thoroughly with pure carbolic acid and then excise it, taking care not to infect the fresh surface thus made, and then plant the grafts on this fresh aseptic surface after which the dressings need not be changed for at least one week.
The excision of the base of scar tissue and planting grafts on healthy clean tissue was a marked advance.
The Ollier-Thiersch method did not fulfil all expectations. Contractures took place under grafts of this type and there was little resistance to mechanical insults. Hence surgeons were constantly trying to find some method by which soft, elastic, resistant healing could be obtained.
Going back to earlier investigators we find that Lawson in London, in 1871, had used successfully for the relief of ectropion a large thick Reverdin graft of the whole thickness of the skin, free from fat. LeFort in France in February, 1872, successfully transplanted from the arm for the relief of ectropion a free graft from which the subcutaneous
