Vermont phÅ“nix. [volume] (Brattleboro, Vt.) 1834-1955, 1884-05-30
NO. %.
necOnstructing = Face--.nsmarkabIe
Surgical Achievement.

Surgical Achievement.
Bertha Kistler, who for eighteen months
has been under treatment by DR.. George f.
Shrady, visiting surgeon Of the Presbyterian
Hospital, left the institution yesterday liv-
ing, grateful monument Of surgical ingenuity
and skill. Bertha Kistler is now about twon-
ty years old, and fifteen years ago she was
treated by an unskillful surgeon in Germany
for a supposed oanoerous growth in the LETT
cheek. The ailment proved TO be Of another
character, but the operation destroyed all
symmetry Of the childs face, leaving a large
hole in the cheek and the mouth and the
nose frighuully distorted. Eighteen months
ago the girl called on DIR. Shrady TO discover
IL anything could be done to remedy her de-
formity. DR.. Shrady held out little encour-
agement to her but at last consented to un-
dertake the task Of building up virtually
new countenance. Soon aftor the first oper-
alton was performed, and in the course of q
year il was followed by sixteen Others Most
Of the face was made over by transpantation
of flesh from adjacent parts. The most i'm
portant step in tho treatment Of the case
was the filling up Of the hole in the face.
For this purpose a large skin flap was want
ed. It was obtained by DIR. Shrady in the
following manner rectangular section of
skin was partially separated from the girls
left arm above the elbow. An inosion was
made in the side of the forehnger Of the
right hand, extending from the first joint
around TO the thumb. The hand was then
brought over to the left arm, and the de-
tached edge of the skin flap was sewed into
the incision in the finger with fine silver
wire. The hand and arm were kept immov-
able by plastic bandages In about q 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 smputated from the arm. The
hand, with the ingrown Zap, was then
brought up to the face, the scarfed skin on
the left cheek was raised and the flap was in
serted underneath. The hand was kept in
position by plastic bandages and a plastic
cap. In three weeks the flap became at
tached to the face the current of nourish-
ment was changed by gradual Rmputation
from the finger, and finally, when entirely
separated from the hand, the skin flap taken
from the arm became the foundation of q
new cheek.
With a natural anxiety DR.. Shrady watched
the growth of the Aesh and at last had the
satisfaction of demonstrating indubitably the
feasibility of 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 rehabli-
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 dis
tortion had disappeared. With the success
of this last operation, which made twenty in
all, the labor was ended, and nothing was
left but to await the healing of the inoisions.
These have at last become satisfactory, and
the girls face is shRpely once more, but, of
course, slightly disfgured by scars. Most of
these, however, are from straight clean cuts,
and 1t is expected that even they will event
uany become imperceptible.
From the first moment of her long mar
tyrdom the girl has not faltered for an in.
stant, but has been impatient for the next
step. Sometimes the doctor would try to
persuade her to forego for time the opera
tion, but she persisted in her desire. A sing
ular feature of the case is that notwithstand-
ing the suffering she must have experienced,
she has grown very fat She has been con-
stantly the recipient of flowers, wines and
delicscies of various kinds from people who,
though strangers 10 her, have become inter
ested in her singular and remarkable patience.
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