fat had been removed. Good results were also obtained by several other men about this time.
In 1875, Wolfe of Glasgow, reported a successful plastic operation for the repair of a defect about the lower eyelid, with a free whole thickness graft from the arm, measuring 2.5×5. cm. (1×2 inches), from which all the subcutaneous fat had been removed. He is generally accredited with introducing this method, and with insisting on the complete removal of the subcutaneous fat, although Lawson, in 1871, and LeFort, in 1872, had done practically the same thing. At any rate to Wolfe is due the credit of establishing the method in ophthalmic practice.
Esmarch and others used the method with success, but to Krause of Altona is due the credit of introducing it into general surgery. The method should be called the Wolfe-Krause method.
Krause reported his perfected technic at the Twenty-second Congress of the German Surgical Association, and advised the use of the whole-thickness graft for all purposes where the Ollier-Thiersch graft had been found lacking. He reported 21 cases, and found that skin from any location could be used after the removal of the subcutaneous fat.
Hirschberg, at the afternoon meeting of the same day claimed priority for the use of whole-thickness skin grafts with subcutaneous fat. He said that hyperemia should be induced before excising the graft with the fat and that this might be accomplished by beating the part with a piece of rubber tubing, thus repeating to a certain extent the old Indian method. He also thought that only skin with a very dense vascular network should be used. Krause opposed these ideas of Hirschberg, and further investigation has proved that there is no advantage in hyperemia and that there is a distinct disadvantage in the presence of fat.
The Wolfe-Krause method was used in suitable cases for some time, but the larger operative procedure as compared with the Ollier-Thiersch method discouraged its general use.
In 1905 Young of Glasgow, suggested various modifications of Krause's technic.
In this brief historical review of the subject I have endeavored to touch only upon the main features in the development of plastic surgery. Many names famous in plastic surgery have been omitted, but I shall endeavor in the pages that follow to give these names prominence in the chapters in which their particular work is considered.
