Slide fixation locks are a valuable addition to the latter, as they hold the blade in place when open. See [Fig. 86].
Fig. 86.—Folding Razor.
The site from which the graft is to be taken is first thoroughly scrubbed and washed, then cleansed with an antiseptic solution. The skin of the anterior surface of the arm or upper thigh is usually chosen. The skin of the part is made tense with the left hand, while the point of beginning is slightly raised by the assistant with the aid of a tenaculum hook. The razor, dipped into sterile salt solution, is now taken in the right hand and by quick sawing movements, the plane side being placed next to the limb, a strip of skin is detached ([Fig. 87]), which, as it is cut, glides in folds upon the concave side of the razor.
Fig. 87.—Method of Cutting Thiersch Graft.
The uppermost layer of the skin is removed, including epidermis, the Malpighian and papillary layers, as well as a small portion of the stroma. Hübscher includes only the epidermis and the upper portion of the papillary layer, with equal success.
The length and width of the strips so removed must be made according to the defect to be covered. Their width may be made as much as two inches and their length not to exceed four inches.
The collected strip of skin, still on the razor, is now brought to the place of grafting and, with the point of a needle placed at its farther end, is slid off upon the part to be covered and allowed to fall in place by the gentle backward withdrawal of the razor blade, as shown in [Fig. 88].