Skin transplantation during the pre-Reverdin era, 1804-1869

In 1869, Jacques Reverdin's classic paper describing the successful use of small, thin human skin autografts heralded an important clinical era in plastic surgery. However, the 65 years prior to this were filled with important technical and biologic development that presaged Reverdin's epochal discovery. Successful free skin autografts were performed by Baronio in 1804, Cooper in 1817, Bunger in 1823, Dieffenbach in 1833 and Warren, in 1840. More than a score of other investigators were unsuccessful with free skin grafts largely because the grafts were too large, too thick, poorly secured and unprotected from infection. In contrast, the use of delayed pedicle skin grafts permitted the successful development of numerous plastic reparative procedures. Numerous investigators, notably Dieffenbach and Bert, made important biologic observations regarding tissue transplantation and the inevitable immunologic rejection processes that ensued.