RECONSTRUCTING A FACE.

Wairarapa Daily Times, Volume 6, Issue 1754, 6 August 1884, Page 2

RECONSTRUCTING A FACE.

Bertha ICistler, who for eighteen months has been nailer treatment by Dr George F, Shrady, visiting surgeon of the Presbyterian Hospital, left the institution the other day a living graceful monument ot surgical ingenuity and skill. Bertha ICistler is now about twenty years old, and fiftejn years ago she was treated by an unskilful surgeon in Germany for a supposed cancerous growth in the left cheek. The ailment proved to be of another character but the operation destroyed all symmetry of the child's face, leaving a large hole in the cheek anul the mouth and nose fearfully distorted. Eighteen months ago the girl called on Dr Shrady to discover if anything could be done to remedy her deformity. She was only a poor working girl but begged to go to the hospital and pay for treatment by work, Dr Shrady held out. little encouragement to her, but at last consented to undertake the task of building up virtually a new countenance. Soon after the first operation was performed, and in the I course of a year it was followed by sixteen others. Most of the face was made over by transplantation of flest from adjacent places. The mo?t important step in the treatment of the case was the filling up of the hole in the face. For this purpose a large skin flap was wanted. Ifc was obtained by Dr Shrady in the following manner:—A rectangular section of skin was partially separated from the girl's left arm above the elbow. An insertion was made in the side of the forefinger of the right hand, extending from the first joint round to the thumb. The hand was then brought over to the left arm, and the detached edge of the skin flap was then sewed into the incision in the finger with fine silver wire. The hand and arm were kept immovable by plastic bandages. In about a week the skin flap became united to the hand, but the flap was principally nourished from the arm, To change the current of nutrition the flap was gradually cut from the arm, and when it had been nearly severed the finger, and not the arm, kept the skin flap alive. When this became apparent the entire skin flap was amputated from the arm. The hand, with the ingrown flap, was then brought up to the face, the scarred skin on the left cheek was raised, and the flap was inserted underneath. The hand was kept in position by plastic bandages and a plastic cap. In three ] weeks the flap became attached to the j face; the current or nonrishment was , changed by gradual amputation from . the finger; and finally, when entirely i separated from the hand, the skin flap j taken from the arm became the fonnda : , tion of a new cheek. With a natural anxiety Dr Shrady watched the growth of the fleah, and j at last had the satisfaction, of demon- ( strating indubitably the feasibility of r transplantation of flesh from one part of the body to another by using the, ( hand, as a medium. New difficulties " then arose. The surface of the face ' was rehabilitated, but the girl's mouth '

was drawn out of shape to such gfe extent that the comer was almost directly under the nose. To restore the mouth Dr Shrady decided to enlarge .it on the other, and after this was dona the lips were cut into the true and proper shape, and all trace 3 of distortion had disappeared, .With the success of this last operation,. which . made twenty iu all, the labor was ended and nothing was left but to await the healing of the incisions. -These - have become at last satisfactory, and the girl's face has become shapely once more, but, of course, slightly disfigured by scars. Most of these, however, are from straight, clean cuts, and il is pected that even they will become imperceptible. From the first moment of her long martyrdom the girl had not faltered for an instant, but has even been impatient for the next step. Sometimes the doctor would try to persuade her to forego for a time the operation, but slie persisted in her desire. A singular leature of the case is, that notwMstanding the suffering she must experienced, she has grown very fat, She lias been constantly the recipient of flowers, wines, and delicacies of various kinds from people who, though strangers to her have become interested in her singular and remarkable patience. —'New York World,' May 2],