The Columbian. [volume] (Bloomsburg, Pa.) 1866-1910, 1884-05-30
Re- Constructing a Face.
EXTRAORDINARY SUCCESS IN THE TRANS
PLANTATION OF FLESH "A
GIRLS PATIENCE.

Bertha Kistler, who for eighteen
months has been under treatment by
DIR. +. Shrada, visiting surgeon OF the
Presbyterian hospital, New York, left
the institution recently living, CRATE
full monument of surgical ingenuity
and skill. Bertha KistIer is now about
twenty years old, and fifteen years ago
she was treated by an unskillful sur
geon in Germany for supposed can
cerous growth in the left cheek. The
ailment proved to be of another char
acter, but the operation destroyed all
symmetry of the child's face, leaving
large hole in the cheek, and the mouth
and nose fiightfully distorted. Eigh.
teen months ago the girl called on DR..
Shrady to discover If anything could
be done to remedy her deformity.
She was only poor working girl,
but begged to go to the hospital and
pay for treatment by work The doc.
tor held out little encouragement to
her, but at last consented to undertake
the task of building up virtually new
countenance. Soon after the first
operation was performed, and in the
course of year it was followed by
sixteen others. Most of the face was
made over by transportation of flesh
from adjacent parts.
| The most important step in the
treatment of the case was the filling up
of the hole in the face. For this pur.
pose large skin flap was wanted. 1t
was obtained in the following manner: !:
A rectangular section of skin was par
TALLY separated from the girls left arm
above the elbow. An incision was
made in the side of the fore6uger OF
the right hand, extending from the
first joint around to the thumb. The
hand was then brought over the
left arm, and the detached edge of the
skin flap was sewed into the incision in
the finger with fine silver wire. The
hand and arm were kept immovable by
plastic bandages. In about 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 entite skin
flap was amputated from the arm. The
hand with the ingrown flap, was then
brought to the face, the SCARED skin on
the left cheek was raised and the flap
was inserted underneath. The hand
was kept in position by plastic band,
ages and plastic cap. In three weeks
current of nourishment was changed
by gradual amputation from the finger,
and finally, when entirely separated
from the hand, the skin flap taken from
the arm became the foundation of a
new cheek.
With natural anxiety the doctor
watched the growth of the flesh, and at
last had the satisfaction of demonstrat-
ing indubitably the feasibility of trans.
pla0tation 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 rehabili-
tated, but the girls mouth was drawn
out of shape to such an extent that the
corner was almost directly under the
nose.
To restore the mouth DR.. Shrady
decided to enlarge it on one side and
sew it up on the other, and after this
was done the lips were cut into the
true and proper shape and all traces of
distortion had disappeared. With the
success of this last operation which
made twenty in all, the labor was end.
ed, and nothing was left but to await
the healing of the incisions. These
have at last become satisfactory, and
the girls face is shapely once more,
but, Of course, slightly disfgured by
scars. Most of these, however, are from
straight clean cuts, and it is expected
that even they will eventually become
imperceptible.
From the first moment of her long
martyrdom the girl has not faltered fol
an instant, but has even been impatient
for the next step. Sometimes the doc
tor would try to persuade her to fore
60 for time the operation, hut she
persisted in her desire. A singular
feature of the case is notwithstanding
the suffering she must have expert
enced, she has grown very fat. She
has been constantly the recipient O.
flowers, wines and delicacies of var
ious kinds from people who, though
strangers to her, have become interest
ed in her singular and remarkable
patience. - From the Nep Yorl
Herald.