It wasn’t so much for the skin itself to take hold, as it was to let the vasculature actually get re-seated in the facial region, which was crucial when it came to preventing immediate necrosis of the grafted skin.
Especially since the full thickness of the dermis was going to be used in reconstructing the region, it would have been almost impossible to get such a large chunk of tissue to spontaneously attach to its host site. By letting it have a healthy vascular connection on one end, while it establishes its “roots” on the other end, the tissue stayed alive, and the person wasn’t left with a dead nose and a flesh wound on their arm.
Surgical patient with a skin flap from the arm transplanted to the nose. From Gaspare Tagliacozzi (1597), De curtorum chirurgia per insitionem, p. 18. Woodcut.
This 16th century volume is the first book on plastic surgery in Europe since antiquity. Tagliacozzi details amputations, skin transplants, and prosthetics for the nose, lips, and ears. The bandages depicted here were designed to hold the arm to the nose for several weeks for the skin graft to take hold.
Apparently, damage to the nose was not uncommon in the 16th century, thanks to outbreaks of syphilis, and duel-related nasal injuries.
Tagliacozzi’s nasal reconstructive surgery. Developed because people kept getting their nose tips cut off in duels.Favorite reason for developing a surgery ever.