Details

Watercolours of skull, necrosis

GC.6975

A.K. Maxwell (Artist)

Three water-colour paintings by A. K. Maxwell showing stages in localized left frontal necrosis of the skull. Of a carter whose laceration of the scalp and the ingraining of the bone with dirt was caused by the grinding action of a cart wheel before which he had fallen. The method of dealing with this case was to excise the margins of the wound and with a chisel to remove the superficial dirt-ingrained surface of the external table and to allow the surface to granulate completely. The margins of the wound were then readjusted and skin grafting done if necessary. The first picture shows the “blush” in the dead external table of the skull. Granulation has commenced in the raw surface of the scalp where there are still several small necrotic areas and there is slight epithelial growth at the margins of the wound. The second picture was made 3 weeks later and shows the granulation scalp wound considerably contracted and that numerous buds of granulation tissue of various size have absorbed and penetrated the dead layer of bone at the site of the several “blushes” seen in the first picture. Almost the whole surface of the bone now shows the preliminary “blush” which precedes resorption. The third picture, which was made 6 weeks after the second, shows the whole of the bone replaced by granulation tissue, the second of two small superficial sequestra having come away 2 days previously and made the wound ready for readjustment.

Nineteenth century, late