Alexandria gazette. [volume] (Alexandria, D.C.) 1834-1974, 1884-05-26
RECONSTRUCTING \ FACE.

RECONSTRUCTING \ FACE.
Bertha kistler, who for eighteen months
has been under treatment by DR.. George f..
Shrady, visiting surgeon of the Presbyterian
Hospital in New York, left the institution
last wcel: Il living, grateful monument OF
surgical Ingenuity and skill. Bertha kistlcr
is now about twenty years old, and fifteen
years ago she was treated by an unskilful
surgeon in Germany for q supposed cam
cerous growth in the left cheek. The all
ment proved to be OF another character, but
the operation destroyed all symmetry Of the
cheek, and the mouth and nose irightfully
distorted. Eighteen months ago the girl
called on Dr. Shrady to discover if anything
could he ;to:c to remedy the deformi;y.
She WAS only :. poor working girl, but
begged TO go to the hospital and pay for
treatment hy work. Dr.. Shrady nc!d cut
little encouragement 10 her, but at last con
7tnted 10 undertake the t;jS!; ur building up
virtually u new vuun!~uanGr. Soon after
inc first operation was performed, and IL
;Ila course o! {" year ii was followed jy eiN-
teen others. Alo&t ot the lace WAS made
over by IransplantatiUn III flesh from ac
jjac@nt parts.
Tho :noS. Important step il the treatment
OF the case was the filling M Of the hole i'll
the face. For this purpose u large skin flap
was wanted Ii was obtained by DR.. Snr,.
d. IL the following !nannner: 4 rcctanSu-
lar section o. skin was partially separated
from the girls left arm above The elbow
An incision was made in the side Of the fore
finger Of The right hand, extending from
thc first joint around 10 the thumb. The
hand WAS then brought over 10 the ictt arm
and the detached edge OF the skin flap was
s;,wcd into the inciSion in the finger with
fine silver wire. The hand and arm were
kept immovahlc by plastic bandase&. In
about II week the skin flap became united
to the hand, but the flap was principally
nourishei from the arm. To change the
current OF nutrition the flap was gradually
cnt from the arm, and when il had been
nearly severed, the tiuger, and net the arm,
kcn. the skin alive. When this hccamc APP
parent the entire skin flap was amputatcd
from The arm The hand, with the ingrown
Hap, was then brought up to the face, the
SCARED skin on the left check raised and
the Hap was inserted underneath The
hand was kept in position by plastic ban
dages and 4 plastic cap. In three weeks
the nan became attached to the face: the
current Of rourishment was changed by
gradual amputation from the finger, and fl
nal!y, when entirely separated from The
hand the skin flap taken from the arm be-
came the foundation OF IL new cheek.
With q natural anxiety DR.. Shrady watch
Cd the growth Of the flesh, and at last had
the satisfaction of demonstrating indubiah-
~ the feasibility Of transplantation Of flesh
from enc part Of the body 10 another by rs
ing the hand IS a medium. New difficulties
then arose. The surface the face was re-
habiltated, but the girls mouth was drawn
out o! shape 10 such an extent that Tic cor
ucr WAS almost directly under The nose.
10 restore the mouth, DR.. Shrady decided
10 enlarge it on one side and sew it up on
the other. and after this MAS done the lips
were cut into the true aud proper shape,
and all traces ofdistorton had disappeared.
With the Success Of this last operation,
which made twenty in all, the labo" was
ended. and nothing was left but 10 await the
healing Of the imcisious. These have al last
become satisfactory, and the girls face is
shapcly once more, but, of course. slightly
disiisured by scars. Most of these, however,
are from straight, clean cuts and il is cX-
pcc;ed that even they will eventually be-
come imperceptiblc.
From the first moment Of her long mar
tyrdom the girl has not ialtercd Tor an in
slant, hui has even been inpatient for the
next step Sometimes the doctor would try
to persuade her to iorcgo for a time the ope-
ratiou. but she persisted in her desire. A
singular feature Of the case is that, notwith-
standing The suffering she must have expo
renccd, she has grown very fat She has
been constantly The recipient Of flowers,
wines and dciicaces Of various kinds from
people who, though strangers TO her, have
become interested in her singular and re-
markabc patience.