The grafting of mucous membrane, both from the animal and man, has been accomplished by Wölfler. His methods are particularly applicable to the restoration of the conjunctiva, mucous membrane of the cheek, etc. Under certain circumstances pedunculated skin flaps have been folded inward to serve as the mucous membrane by Gersuny. When mucous-membrane flaps were taken from the animal, the conjunctiva of the rabbit has been preferred.
Under peculiar circumstances, though rarely, mucous-membrane flaps may be utilized to cover denuded skin areas. The mucous membrane, in such cases, in about ten days takes on the appearance of the skin.
Ofttimes, when it is impossible to obtain foreign mucous membrane, grafts may be taken from the inner surface of the lips of the patient. These grafts answer exceedingly well for conjunctival restorations, while the wound occasioned by their removal is closed by suture or allowed to heal by itself, if not too large, under boric-acid antisepsis.
BONE-GRAFTING
Bone-grafting, as followed by MacEwen, Ollier, Poncet, and Adamkierwicz, has been more or less successful. Their methods have been often employed in plastic facial surgery, as will be shown later. Their methods were later improved by Senn, who advocated chips of decalcified bone in place of bone taken from young or new-born animals, from which the bones under ossification have been utilized.
Glück’s method of introducing pieces of ivory into bone defects may be of interest, but is applicable only to long bone implantations. The success of his method has yet to be practically demonstrated. Zahn and Fisher have used various foreign substances to overcome bone defects, but these do not interest the cosmetic surgeon to any extent, since other methods have been proved to give better results. These, however, belong to the subject of subcutaneous prothesis, and must be considered separately thereunder.
HAIR-TRANSPLANTATION
It may be of interest to know that Schweininger and v. Nussbaum have attempted to graft hairs upon granulating tissue by sprinkling the hairs, with their attached roots, upon the surface to be covered. If any of these lived and attached themselves the root sheath formed a scar center, and the hair dropped out after several days.