THE UNIQUENESS OF THE INDIVIDUAL 



the skin but arranged in a different and functionally ineffective 

 pattern. In the meantime, the edges of the wound are forcibly 

 drawn together by the tensile forces generated within the 

 granulation tissue: this is the process of contracture. In rabbits 

 and other mammals with a loose integument, contracture is the 

 normal mechanism of repair, and it works admirably, for a 

 rabbifs skin is so mobile that the edges of the wound can be 

 drawn together into the neatest possible natural line of suture. 

 Human beings retain the mechanism of healing by contracture, 

 but human skin is so firmly bound to the tissues underneath it 

 that contracture is no longer an efficient method of repair; the 

 edges of the wound are forcibly dragged inwards, instead of 

 giving easily, and the skin around is gathered up and distorted. 

 (Mere disfigurement is one of the lesser evils, for in certain 

 parts of the body contracture can constrict the blood-vessels, 

 acting like a tourniquet, or immobilize a joint.) The end-result 

 of this entirely inept process of repair can only be described as 

 functionally and cosmetically abominable. A greater or lesser 

 scar is left, made of dense fibrous tissue, and covered by a 

 sometimes unstable and always unsightly surface layer of 

 epithelium which never regains its natural suppleness and 

 colour nor grows anew its normal endowment of glands and 

 hairs. But before the surgical innovations I am about to 

 describe came into common use, to achieve even such an end- 

 result as this would be a matter for congratulation, for ''naturaP 

 repair is a dilatory process that gives the patient every reason- 

 able opportunity to die from the steady seeping away of body 

 fluids through the wound's raw surface, or from the wound 

 infections that, without the help of antibiotics, an already 

 enfeebled body could do little to oppose. 



For this appalling problem, the surgical operation of skin 

 grafting provides an almost complete solution. What is done, 

 as a rule, is this. A broad, thin sheet of skin is removed from 

 some uninjured part of the patient"'s body, most conveniently 



144 



