The strips of epidermis wrinkle up on the knife and are directly transferred to the surface, for which they should be made to form a complete carpet, slightly overlapping the edges of the area and of one another; some blunt instrument is used to straighten out the strips, which are then subjected to firm pressure with a pad of gauze to express blood and air-bells and to ensure accurate contact, for this must be as close as that between a postage stamp and the paper to which it is affixed.

As a dressing for the grafted area and of that also from which the grafts have been taken, gauze soaked in liquid paraffin—­the patent variety known as ambrine is excellent—­appears to be the best; the gauze should be moistened every other day or so with fresh paraffin, so that, at the end of a week, when the grafts should have united, the gauze can be removed without risk of detaching them. Dental wax is another useful type of dressing; as is also picric acid solution.  Over the gauze, there is applied a thick layer of cotton wool, and the whole dressing is kept in place by a firmly applied bandage, and in the case of the limbs some form of splint should be added to prevent movement.

A dressing may be dispensed with altogether, the grafts being protected by a wire cage such as is used after vaccination, but they tend to dry up and come to resemble a scab.

When the grafts have healed, it is well to protect them from injury and to prevent them drying up and cracking by the liberal application of lanoline or vaseline.

The new skin is at first insensitive and is fixed to the underlying connective tissue or bone, but in course of time (from six weeks onwards) sensation returns and the formation of elastic tissue beneath renders the skin pliant and movable so that it can be pinched up between the finger and thumb.

Reverdin’s method consists in planting out pieces of skin not bigger than a pin-head over a granulating surface.  It is seldom employed.

Grafts of the Cutis Vera.—­Grafts consisting of the entire thickness of the true skin were specially advocated by Wolff and are often associated with his name.  They should be cut oval or spindle-shaped, to facilitate the approximation of the edges of the resulting wound.  The graft should be cut to the exact size of the surface it is to cover; Gillies believes that tension of the graft favours its taking.  These grafts may be placed either on a fresh raw surface or on healthy granulations.  It is sometimes an advantage to stitch them in position, especially on the face.  The dressing and the after-treatment are the same as in epidermis grafting.

There is a degree of uncertainty about the graft retaining its vitality long enough to permit of its deriving the necessary nourishment from its new surroundings; in a certain number of cases the flap dies and is thrown off as a slough—­moist or dry according to the presence or absence of septic infection.