MORPHOLOGICAL-CHANGES AND WOUND-HEALING I N KUTISPLASTIK-TECHNIQUE FOR ABDOMINAL-WALL DEFECTS - AN EXPERIMENTAL-STUDY

Ther aim of the experimental study was to investigate the morphology a nd wound healing of ''Kutisplastik''-technique, originally introduced by Loewe (1913) and Rehn (1914), from different conditions. We want to clarify the mechanism and development of revascularisation. Results: The well known phases of wound healing also appear in the situation of a cutisplasty. In the exsudative reaction the cutis is covered from f ibrin fibers. This leads to the development of granulation tissue. The cellular reaction demonstrates first the ingrowth of capillary bundle s and vessels in the collagen network of cerium. The revascularisation is finished up to 14 days after the operation. The other part is the immigration of granulocytes and macrophages in the graft. The release of enzymes leads to the lysis of epidermal structures, cutaneous appen dages and at least to collagen fibers of cerium. There is also a proli feration from fibroblasts. The genesis from new collagen fibers is the n observed so a scar tissue reveales. The ''Kutisplastik''-technique c ontains that the epidermal side of the graft is turned upside-down tow ards the peritoneum and is sutured under as high tension as possible t o the healthy fascia arround This morphology of healing is seen only u nder high-tension suturing. In the experimental mode of non-tension su turing there is a lack of success in cutisplasty for abdominal wall de fects.