It has been my custom every year or two to request our patients operated on for mammary cancer and living in or near Baltimore to come on certain mornings to the surgical clinic of the Johns Hopkins University in order that we may observe the ultimate result, particularly with reference to the function of the arm.
For about sixteen years our practice has been to cover the fresh defect, made as small as feasible in various ways, with large Thiersch grafts. The available skin was tucked high into the armpit in order to cover the axillary vessels, to obliterate the dead space under the clavicle, and to elevate to the highest possible point the axillary fornix.
The tip of the axillary flap was usually cut away. Notwithstanding this precaution a little necrosis of the badly nourished flap was not infrequently observed, and as a consequence there occurred an occasional but
HALSTED WS. DEVELOPMENTS IN THE SKIN-GRAFTING OPERTION FOR CANCER OF THE BREAST. JAMA. 1913;60(6):416–418. doi:10.1001/jama.1913.04340060008004
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