NEW FACES FOR OLD

Dominion, Volume 8, Issue 2376, 4 February 1915, Page 7

NEW FACES FOR OLD

REPAIRING THE HAVOC OF SHOT AND SHELL (By : ffiffier.) v .j Paris. y&iitl experience to see men Joeing fitted , with .new faces. ]. It is a revelation of what modern surigery can do to repair the ravages of ■modern, war. Into the hospital where .these miracles aTe worked-men come with faces half, shot away, with fragments of. jaws, sometimes with scarcely •any teeth,' and they leave it as if they -had visited a beauty doctor's establishment. It does not always take so very Hong either. , Where 1 saw theso wonders is at the American Ambulance Hospital at Neuilly.' Here these marvellous results are obtained, through the co-operation of tho dental and the plastic surgeon, rf>isults which it is scarcely possible to believe in without ocular proof.' The dental surgeon attends to the fractured and splintered bones and missing teeth, and the plastic surgeon's part is .to deal with the ravages to the flesh by grafting and sewing and folding of skin and flesh. I saw some of the photographic records which are kept of all the cases treated. You can place half a dozen in a row and see the transformation from a mangled visage to a .handsome, smiling countenance. In taany cases it is impossible to recognise the same man "before and after.' Someof the details are rather medical, but it is due to-.those who perfoiin these .extraordinary feats of surgical sleight-of-hand that; a- few should, be "described. . '," .

j Calling in the Dentist. Up 'to a certain point the.treatmenii follows well-defined lines. It 'frequently, happens that if the man is struck by a bullet fired at comparatively short range an explosive effect is, produced when the projectile hits a bone, and then the worst damage is done. The dental surgeon-first takes the case in hand. He cleans the whole mouth, including eveiy single tooth. Then tho jaw is placed in splints to keep thft fractured ends in apposition, and to ensure that the jaw sets in its proper position. In the worst cases a part oi the buue'is often carried right away, ■whoa in artificial substitute has to be provided. As a rule, when the destruction is _so complete, the perivosteuin, or bone-depositing membrane which surrounds has been destroyed '■ too, and the bono will not form again by itself. Then the plastio surgeon takes matters in hand.; In the less serious - oases the wound can heal by granulation (the ordinary.method of healing in an infected wound) in the usual manner after the sides have been, .'drawn together, but in the great majority of the cases whore the tissue has Keen destroyed or evon carried away, and a gaping'hble has been left, skin or flesh has to be supplied and moulded and •wrapped 1 into position, leaving Nature to i effect the complete amalgamation. It is •jnot easy to convey in words the delicacy ,ni these operations. ._ . \ One of the most remarkable achieveiinents ofthe surgeons of this hospital i-who' are specialising in this class of work was the. actual reconstruction of the face of an Algerian soldier, who had been struck by a large piece of ■ shell. The missile entered high up in the left .'cheek, ploughed downwards through the roof of the mouth, which was almost destroyed, and made its exit Tby smashing through, the lower jaw >on ine right-hand side. It did not seem lhati the man , could- ever be made to Hook ■ presentable again, but the thing was done, and that Algerian was a much handsomer man when the surgeons had finished with him than before the piece tof shell carried away most of his face. 'A roof for the mouth 'was made of metal end hard rubber, and the missing sections of bone in the cheek and jaw. were leplaced artificially. The gaping wounds in the-face were closed by clever manipulation, of the flesh, and Nature accomplished the rest. Except for a rather ■exaggerated dimple in the man's cheek ithere was nothing to show that, he had ■virtually been furnished with a tew face. Another remarkable piece of work waa ! that performed on an Englishman who had received a shrapnel bullet clean through his face. "It was possible to look through both checks to daylight as through a window. Again the jjrafting of Seen combined with clever dental surgery was so well managed that the only sign the man's friends jnight have noticed of his wound was thaVhis noso had become handsomely Grecian, whereas . before, it had been JRoman, .: ' :. ■'.■ .■: Dummy Bones. It is an interesting fact that in the iigreat majority of these, terrible face .Wounds the projectile has struck in a (downward direction. It was owing to this fact that a certain soldier found liimself minus the tip of his nose and the upper front part of his-mouth.- A 'dummy , section of bone was made for him containing the necessary teeth.to restore the contour of the mouth, and then the plastic. surgeon took some skin from his neck and leg and eunning;ly :Used it to restore the upper lip. :fi'he nose was repaired by grafting flesh «ra to the remaining portion. The re- 1 suit was perfect in. both cases, and I >as' assured that when tho soldier was •discharged the profile of his face was absolutely classic. It has happened in Home cases that a patient has been Setter looking after hia .wound has fceen healed than before his features •were devastated by the bullet. The enterprising spirit which prompts . the successful; accomplishment of these ■unusual surgical ventures is evident in manj; departments of this admirably conducted hospital with its wonderful equipment. There being no-lift available, inclined-planes' have been conktiucted over several of the staircases, a simple but thoughtful idea to facilitate the transport of patients from the wards to.the operating theatres and Xriays room.