[Morphology and healing of skin repair in abdominal wall defects. An animal experiment study]

The aim of the experimental study was to investigate morphology and wound healing following the skin plasty ("Kutisplastik") technique originally introduced by Loewe [11] and Rehn [17] under different conditions. We wanted to clarify the mechanism and development of revascularisation.

The familiar phases of wound healing take the usual course after a skin plasty. In the exsudative reaction the cutis is covered with fibrin fibres. This leads to the development of granulation tissue. The cellular reaction takes place in two parts: first comes the ingrowth of capillary bundles and vessels in the collagen network of corium; revascularization is complete within 14 days after the operation. This is followed by the immigration of granulocytes and macrophages into the graft. The release of enzymes leads to the lysis of epidermal structures, cutaneous appendages and ultimately to collagen fibres of corium. There is also proliferation from fibroblasts. Genesis from new collagen fibres is then observed as scar tissue. The skin plasty technique involves turning the epidermal side of the graft to the peritoneum and suturing it under the highest tension possible to the surrounding healthy fascia. This course of healing is seen only with such high-tension suturing. Experimental nontension suturing has led to failure of skin plasty for abdominal wall defects.