NEW FACES FOR OLD

Evening Post, Volume XCV, Issue 24, 28 January 1918, Page 8

NEW FACES FOR OLD

REMEDIES FOR WAR

WOUNDS

PLASTIC SURGERY

(FROM ODIt OWN CORRESPONDENT.)

LONDON'S 16th November.

Many of the men who come back by the Via Dolorosis from the trenches to the English countryside, have their faces 60 damaged that they will not heal, but ■will gangrene and cause death. Others are wounded in a healthy enough way, and the wounds might heal, but the loss of a complete jaw, or even more, ■will prevent the patient from masticating or swallowing food, and so cause death. Before the great war men with shattered faces died of wounds or broken hearts. Now they go to a special hospital, where marvels of surgery are performed, and step out into the world again whole and confident. I found the hospital for facial cases at Sidcup, Kent, in the grounds of Frognal—a seat of the Sydney family, and the home, in peace time, of the Hon. Mrs. Robert MarshamTownshend. It is chiefly a hutment hospital in the beautiful park. The Commandant, I was flattered to discover, is a New Zealander, Major D. H. Gillies, R.A.M.C., who before the war had a Harley-street practice , and was well known in the golfing world.

Frognal accommodates about 350 in-patients, but there are another 150 billeted in the neighbourhood, and coming in for their surgical treatment. It has been, going as. a special hospital > for more than a year, and to-day it is the Mecca of the face and head specialists, as Roehampton is of the limb specialists.

The raison d'etre of Frognal is, in a word, to renovate damaged faces. The order of reference extends not merely to skin and superficial injuries, but to actual making of new faces'.where the old ones have been damaged beyond repair.

To begin with something simple. A seaman in the battleship Malaya at the Battle of Jutland had the whole of the skin burnt off the front of his face in a cordite explosion. It was healthy enough, but it was raw flesh, and would not mend. The process adopted was this: The skin of the chest was cut away to a depth of about a quarter of an inch, and rolled back downwards, making a scroll sufficient to cover the face. It was then laid over the face and kept firmly in position, the lower end. being still attached to the chest to keep the blood circulating. In a fortnight the flap had taken root ou the raw flesh of the face. It was then cut off round the chin, and what was not required was replaced on the chest, 1 being drawn over tightly to close the. gap left by the piece that was transplanted. The apertures for the nose and throat were then cut, and the man went out of hospital with a perfectly healthy face.

!A remarkable case was that of a young officer of the R.F.C., whose face was practically -burned off by his machine taking fire in the air. ■. When he came into hospital he was alive and no more. The whole face had gone. The eyes Wtere destroyed and scarcely visible in the > empty sockets. The v nose was burned completely off, the two apertures opening direct into the skull. The photograph looked like that of a skull. It only remains to be said that the officer has now a face not badly disfigured, and that though he has lost his sight his other faculties are unimpaired.

MAKING NEW NOSES.

The making of now noses is an everyday matter at Frognal. A flap of skin is raised from the cheeks and turned back on the forehead. Upon this the new nose iis built and started growing. Working from pre-war photographs of the patients, a cast of the nose is made from which to build. The pieces of cartilage are taken from below the eighth rib, wehre there is a good wide expanse, and if any bone is required it is taken from that rib. The cartilage thrives vigorously after transplantation, but the bone is not such a ready grower, and has to be watched carefully. When the whole structure is. well rooted, the flap with the new nose is swung round to its proper place, and left to grow there. Very few noses fail; when they do it is generally due to absorption^ of the tissues causing them to collapse.

Jaws and teeth are also made habitually. It is not uncommon for a man to have the whole lower jaw blown away, so that, although quite healthy, he is unable to take food or to speak. The staff at Sidcup enter upon such a job with professional joy. The man is put on the table for a double operation. One surgeon opens the side and removes from the rib the required pieces of bone for the new jaw, while another, working on the head, grafts the pieces into their new position.; Every stage must be allowed. to work itself out before another is entered upon, so as to-be sure that the transplanted bone has taken healthy root, and is growing. Flaps of skin and flesh from other parts of the face and body are then drawn over to make the fleshy part, and, finally, in the mechanical dentistry department, a new "lower set" will be evolved and fitted into the new lower jaw. The case is finished off by .the necessary massage to restore the damaged muscles and shape the tissues as before. ARTISTIC FINISH. ) Nor are the surgeons anything less than artists at their profession. They are most particular what skin to use for what jobs. The new nose is usually clothed in a piece stolen from the forehead. There is a case on record—from the early days—in which it was cut slightly too far up, into the hair, with the melancholy result that a soldier who is glad enough to have a presentable i face at all has now to shave one side of his nose regularly. . A chin incapable of growing a beard would not satisfy the surgeons. As a rule they take a strip from the scalp, turn it down and lay it over the chin for a week or two until it grows, then cut off what is not required and return it to the head. There is practically no injury to the face which cannot be very largely remedied by plastic surgery, and, unquestionably, army medical services of the' future will regard it as part of •tlreir legitimate duty to return their maimed soldiers to civil life as nearly as possible restored to their old selves, not only in health, but also in appearance. New Zealand, I am glad to say, is taking an oar in Sidcup for the benefit of her' unfortunate soldiers, as she does at Roehampton. One of the New Zealand patients (Rflmn. Kihvorth,. of Canterbury), I met playing billiards in the recreation room. '

Gen. Richardson paid a visit to Sidcup a few weeks ago, and the D.D.M.S, (Col. Parkes) has now attached Major H. P. Pickevill, N.Z.M.C. (Dvmedin), for duty there.' It may be remarked en passant that Sidcup, like Roehampton, has a fully equipped re-education side, where men in search of technical training or a new trade can go on with it while their surgical treatment is running through its necessary prolonged course.

The Queen paid a visit to Frognal yesterday, and was much interested in the marvels of Major Gillies's command.