SHAFFER J O
Calif Med. 1956 Jul;85(1):10-4.
Graft of dermis is clinically and experimentally superior to graft of whole skin for use as reinforcement at the site of repair of hernia, for gross cysts do not form and it fuses better with the surrounding tissues than does whole skin. Placing either dermis or skin under tension helps prevent cyst formation and aids fusion with surrounding tissues. Dermal grafts are less liable to infection than are whole skin grafts, either at the time of operation or later.A split-split flap dermatome technique is presented as a preferred technique for obtaining a dermal graft from the thigh in cases of ventral hernia in which the abdominal skin is stretched, attenuated and inelastic because of the massive size of the hernia. This technique was used in 27 cases of massive hernia. There was infection in one case of the 27 and subsequent healing was satisfactory. One patient died of spontaneous rupture of an intracranial carotid aneurysm. Hernia did not recur in any patient.A split-split free graft dermatome technique is presented for use in cases in which an elliptical segment of normal skin can be removed adjacent to an inguinal or thoracic incision for repair of a hernia or other use. This technique was used in seven cases of inguinal hernia and in one of diaphragmatic hernia with satisfactory results.
在疝修补部位用作加强材料时，真皮移植在临床和实验上均优于全层皮肤移植，因为不会形成大囊肿，且与周围组织的融合比全层皮肤更好。在张力下放置真皮或皮肤有助于防止囊肿形成，并促进与周围组织的融合。无论是在手术时还是术后，真皮移植比全层皮肤移植更不易感染。对于因巨大疝而导致腹部皮肤拉伸、变薄且无弹性的腹疝病例，提出了一种分层分叶皮片刀技术，作为从大腿获取真皮移植片的首选技术。该技术应用于27例巨大疝病例。27例中有1例发生感染，随后愈合情况良好。1例患者死于颅内颈动脉瘤自发性破裂。所有患者均未复发疝。提出了一种分层游离移植皮片刀技术，用于在腹股沟或胸部切口附近可切除椭圆形正常皮肤段以修补疝或作其他用途的病例。该技术应用于7例腹股沟疝和1例膈疝，效果良好。
