The punch that Edward Keyes introduced in 1879 was used in its original form in the United States until the late 1950s. 1 Noel Robbins stated that there was a straight cylinder punch made by a German dermatologist, E. Kromayer, in 1905 (Noel Robbins, written communication, December 1981). Kromayer called the punch the "zylindermesser" and reported that it gave excellent results for making deep punches in the skin to remove all kinds of scars in various skin disorders. However, this technique for "scarless surgery" with knives did not appeal to his colleagues and was soon forgotten (Noel Robbins, written communication, December 1981). The design of the Keyes punch is similar to the punches that were used in woodworking and leather shops and to the industrial punches called the Arch punch , all of which were designed with a thick wall to withstand the blow of a mallet. This much force was