The sun., 1886-12-02

Successful Performance OF n Very
Delicate Operation.


Delicate Operation.
There is, says New York special,
very interesting operation going on at
present at Roosevelt Hospital 1t was
begun over three weeks ago. and it will
probably take as much longer for the
wounds to heal. 1t is one of those
plastic operations, which usually have
to be done in sections. Its success is
assured, as the most important part of
it has been performed without any
drawback
The patient is Robert McKeckney, a
young man, who came from Yonkers
to the hospital for treatment. The pa
tent, upon his admission. was greatly
emaciated and weak. The color of his
skin indicated low blood supply.
Some seven months ago he was severe
ly burned by the explosion of kero-
sene lamp, which set fire to his cloth
ing. The burned surface extended
over large section of his body, the
worst place being upon the left side in
the obliquus externus and transversalis
abdomnis muscles. Being of strong
constitution he rallied from the shock.
During months of suffering the wounds
upon his chest healed slowly under
soothing treatment; but on the left
side. covering a space several inches
square, was spot that showed unusual
obstinacy, and despite every sort of
medical application it could not be
healed.
An examination of the young mans
body when he was admitted to the hos
pital, a month ago, demonstrated to
the house surgeon that SO much flesh
upon the left side was electrical and so
much of the skin had been destroyed
in the neighborhood of the liberated
surface, that there was no possibility of
its healing naturally, as there was no
material to throw off the little shoots
of skin. If it could be healed, it
would have to be done by grating the
skin from some healthy portion of the
body. So an operation was determined
upon, the object beng to make a new
side for the patient.
1t took less ether to bring on
annsthes in this case than had ever
been before seen IN this hospital. The
first step in the operation was to re-
move all the dead flesh from the side
of the body. THIS required some very
fine dissectlng, as every particle of
good flesh which could be saved was of
advantage. All the little ragged
edges were carefully cut away, and the
whole surface was made as smooth as
possible. No vessels of Importance
were touched, so the hemorrhage was
slight, and the raw flesh was allowed
to remain covered with blood, to facili-
tate the operation. Fortunately the
left arm of the patient had not been
burned above the wrist. While the
left hand was twisted slightly inward
the surgeon marked out several long
narrow strips in the flesh of the fore
arm with scalpel. The arm had been
muscular and of large size, but had
become labby and more suitable for
the work. When three stripes had
been cut, with q narrow piece of skin
beneath them, the upper ends were
severed near the elbow. With a
keen knife the three pieces of flesh
were dissected up from the arm, be-
ginning at the top, until they were
about six inches long AS each one
was cut loose it was laid back in it's
place in the warm blood until all three
were ready. The strips were kept
joined each to the arm at the lower
end. and while they were yet warm
and palpitating they were placed upon
the raw flesh in the patients side, with
little distance between them, and held
firmly in position until the blood around
them had become slightly coagulated.
These three strips did not cover the en-
tire unhealed surface, and the object of
making three strips instead of one large
one was to gain more space by placing
them little ways apart in the hope
that new skin, if the grating proved to
be successful, would be developed from
each section, and would fill up the va
cant places. In addition to these long
pieces of flesh, smaller pieces were
taken from the patients thigh and
laid upon other portions of the exposed
surface. In order that the patient s
arm might be held firmly in position,
so that no strain could come upon the
strips of the flesh, pieces of sticking
plasture were heated and wound around
the arm and then fastened to the abdo-
men. the side, back and thigh. This
made an even pressure all around and
held the arm SO that it could not be
moved in any way. The wound having
been treated antiseptically, the whole
abdomen was bandaged lightly and the
patient taken to his cot.
The effect of the other passed away
as easily as it had been produced, and
the shock from the operation was
slight. Ehs wound was watched care
fully every day, and every sign of
sloughing that appeared was immedi-
ately cut away. Four of the small
pieces which we're put on were taken
away in the first three days. Others
were taken from different portions of
the body and put in their places and in
different spots until they took root and
held fast, Sc. that the new skin on the
side was in different stages of devel-
opment all the time and made an in
teresting study. In all. forty-two
small pieces of flesh were tried, and
about half of them took root. The
strips of the flesh did not slough any
and presented healthy external appear
ance at all times, and the exudation of
pus having been light, it was consider
ed that there had been good union.
When they were cut loose from the