57.7 Grafting with open knife or a razor

An expert can cut a skin graft with any very sharp knife and a block of wood to keep the skin tense, so can many auxiliaries. The best knife is an ordinary carbon steel carving knife, not a stainless steel one, carefully sharpened. Take your knife to a barber, ask him to show you how to sharpen it. You will need two stones, a medium and a very fine one, and a strop. Sharpening the knife may take you an hour to begin with, but keeping it sharp subsequently only takes a moment. Keep the blade oiled.

Figure 57.9: CUTTING GRAFTS WITH A MODIFIED SAFETY RAZOR. File away the central lug. Make a shim (distancing piece) by grinding away the edges of an old blade. Kindly contributed by Peter Bewes.

Figure 57.10: CUTTING A SPLIT SKIN GRAFT WITH A OPEN KNIFE. The best knife is an ordinary carbon steel carving knife, not a stainless steel one, carefully sharpened. Kindly contributed by Peter Bewes.

GRAFTING WITH AN OPEN KNIFE Soak the knife in cetrimide for 30 minutes. Ask your assistant to kneel beside the patient, and to cradle the skin of the patient’s thigh in his hands as in C, Fig. 57-5, to stretch it slightly, and to keep it flat.

Lay the knife on the patient’s skin at about 5 to 15. Steady the skin in front of it with a wooden block or tongue depressor. Then with short to–and–fro movements, move the knife forwards, and adjust the cutting angle as necessary.

Figure 57.11: GRAFTING WITH A RAZOR BLADE. A, shows how you can cut a narrow sheet graft with half the blade of a safety razor. B, to I, shows the stages in a pinch graft, including the excision of the donor area. Kindly contributed by Peter Bewes.