Hb. Reith et al., MORPHOLOGICAL-CHANGES AND WOUND-HEALING WITH THE SKIN PLASTY TECHNIQUE FOR ABDOMINAL-WALL DEFECTS - AN EXPERIMENTAL-STUDY, Langenbecks Archiv fur Chirurgie, 379(1), 1994, pp. 13-19
The aim of the experimental study was to investigate morphology and wo
und healing following the skin plasty (''Kutisplastik'') technique ori
ginally introduced by Loewe [11] and Rehn [17] under different conditi
ons. We wanted to clarify the mechanism and development of revasculari
sation. Results: The familiar phases of wound healing take the usual c
ourse after a skin plasty. In the exsudative reaction the cutis is cov
ered with fibrin fibres. This leads to the development of granulation
tissue. The cellular reaction takes place in two parts: first comes th
e ingrowth of capillary bundles and vessels in the collagen network of
cerium; revascularization is complete within 14 days after the operat
ion. This is followed by the immigration of granulocytes and macrophag
es into the graft. The release of enzymes leads to the lysis of epider
mal structures, cutaneous appendages and ultimately to collagen fibres
of cerium. There is also proliferation from fibroblasts. Genesis from
new collagen fibres is then observed as scar tissue. The skin plasty
technique involves turning the epidermal side of the graft to the peri
toneum and suturing it under the highest tension possible to the surro
unding healthy fascia. This course of healing is seen only with such h
igh-tension suturing. Experimental non-tension suturing has led to fai
lure of skin plasty for abdominal wall defects.