MORPHOLOGICAL-CHANGES AND WOUND-HEALING WITH THE SKIN PLASTY TECHNIQUE FOR ABDOMINAL-WALL DEFECTS - AN EXPERIMENTAL-STUDY

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.