Dr Thomas Meares1
1Gold Coast University Health, Mermaid Beach, Australia
Though Mr Thomas Graham Humby was not the first to employ a grafting knife his contribution to burns treatment and care cannot be understated.
The first recorded description of the Humby knife as we use today comes from a small article in the 1934 BMJ edition that describes an “apparatus for skin graft cutting”. His initial design was simply to add a roller to the already well-known Blair (1930) grafting knife that could be calibrated to adjust the grafts thickness. Simple yet highly effective. His rigid frame was strapped to the skin and “tiny needles…at either end pierced the skin…[which] allow stretching of the skin surface”. A knife “seven inches long and wafer thin” is then inserted into the framework and slide along the taught skin. Within the next two years Humby had further modified “graft cutting razor, “discarding the rigid framework and solely relaying on the pressure of the knife to determine the width of the graft.
Interestingly during this time of apparatus modification, Humby only made mention of its ability to take full thickness grafts: “In thickness, color and small tendency to contract, the full thickness graft is the most suitable one in 99% of cases”. Though Graham Humby wrote seven papers during the 30’s and 40’s only 3 reference modifications to the original framework idea. Figure 1 shows the initial apparatus to the 1936 modification while figure 2 emphasis the linear progression of grafting knife modifications.
Clarkson P. The Humby. Br Med J. 1952;2:1101
Humby G. Modified Graft Cutting Razor. Br Med J. 1936;2:1086
Humby G. Apparatus for Skin Grafting. Br Med J. 1934;1:1078
Chick LR. Brief history and biology of skin grafting. Ann Plast Surg. 1988;21:358–65
Dr Thomas Meares is a current Plastics PHO at the Gold Coast University Hospital