History of Skin Grafting: Ode to Dr. Otto Lanz

Background

It usually takes many years for new techniques to translate into medical practice. While this can be due to several reasons, it often results in significant delays in medical advancement. For instance, shifts in societal and cultural norms can lead to different techniques or procedures being ‘lost’ to the field when certain practices are prohibited. It sometimes takes years for initiatives to reemerge, and dutiful research to recognize the true historical origins. In skin grafting, one such example is that of Dr. Otto Lanz’s Hautschlitzapparat invention, the instrument considered to be the prototype of the device now used to create skin mesh grafts. This paper aims to provide a brief overview of the history of skin grafting with a focus on how Lanz’s theory and device for what is now known as a meshed skin graft did not become mainstream practice until decades later.

Methods

A literature search in PubMed and Google Scholar on the history of skin grafting and the contribution of Dr. Otto Lanz to this field was conducted. The keywords used in the search criteria were “skin grafting” and “Otto Lanz”. The results were summarized into a narrative discussion, along with a brief biography of Dr. Otto Lanz.

Results

The prototype for the skin grafting device is credited to Dr. Otto Lanz who invented the Hautschlitzapparat (Skin Slit Apparatus) in 1907. This device was similar to the scarificator apparatus that existed since at least the 16^th century. However, Lanz was the first to propose its use for expanding skin grafts, and instruments thereafter were based on the principle laid out by Otto Lanz. It took almost three decades for Lanz’s insight to fully translate to methods of skin grafting procedures utilizing mesh grafts.

Conclusion

Dr. Otto Lanz can be viewed as one of the pioneers of skin grafting as his invention laid a foundation for what is now known to be the skin mesher. The mesher has revolutionized skin grafting procedures by reducing the required size of donor skin grafts as well as the time for healing. The time delay between Dr. Lanz’s invention and the mainstream use of meshers demonstrates, once again, the time it usually takes for the translation of innovative ideas into practice.