OBSTRUCTION TO THE LYMPH CHANNELS BY SCAR

Abstract

Transplants of skin and the underlying soft parts, whether they are made as free grafts at one sitting, or as Italian plastic operations in several stages, are prone to be the seat of an annoying edema. Both the free graft and the Italian plastic transplant are islands of tissue completely surrounded by scar. In both of them edema is likely to persist for a long time, if not indefinitely; and also, when once it has disappeared, to recur. This edema is much less common in pedicled flaps, even in those in which only a very narrow pedicle is retained. In an attempt to inquire into the causes of this edema, I undertook some experiments with the help of Drs. Thompson, Eiskamp and Meherin. Once embarked on them, I have been led afield; questions have arisen that have a bearing on the causes of elephantiasic edema in general. Clinical observations made