THE UNIQUENESS OF THE INDIVIDUAL 



the thigh, laid upon the area from which skin has been lost, 

 and held firmly in position for four or five days until the 

 primary union of the graft to the tissue underneath it is com- 

 plete. The area from which the graft was removed will heal of 

 its own accord within a week or two, for the graft will not have 

 been cut so thick that epithelium from the inner ends of the 

 truncated hair roots cannot creep upwards and grow over the 

 denuded surface; indeed, one donor area can provide more than 

 one crop of skin. 



The use of grafting to make good the loss of skin is satis- 

 factory for wounds up to, perhaps, one square foot in area; 

 but (in the form in which I have described it) it becomes less 

 and less satisfactory as the area of the wound increases, and 

 a severely burnt patient may well have lost far more skin than 

 can be wholly made good from his own resources. The area of 

 loss cannot now be fully covered with grafts; what is done, 

 therefore, is to ''seed'' it with small patches of skin in the shape 

 of squares or rectangles, evenly spaced apart. The outgrowth of 

 epithelium from these little skin grafts, combined with in- 

 growth from the wound margins, forms a new skin surface, and 

 contracture, though it still happens, is reduced in proportion 

 to the area that has been covered with grafted skin. This 

 operation of patch-grafting is avowedly a makeshift; the end- 

 result is neither elegant nor functionally more than serviceable; 

 but it is designed to save a life which might otherwise have 

 been despaired of, and so it does. 



What is interesting to the biologist, however, is not what the 

 surgeon does in such a predicament but what he does not do. 

 If a patient cannot afford skin of his own for grafting, why not 

 use skin grafts from someone else? There is no surgical obstacle 

 to such a procedure, and voluntary donors are not hard to 

 come by; nor would there be any difficulty in setting up a 

 'skin bank** to be drawn upon in an emergency, for skin may 

 be stored alive and without deterioration for a good six months 



K 145 



