invited by Gillies to use her creative gift to sculpt missing noses, ears, cheeks and chins on to a model of the shattered face.
Without anaesthetic the operations would have been intolerable and pain-relief systems were not wholly reliable. But Rubens Wade worked out a way of delivering anaesthesia to a patient in the sitting position, reducing the risk of the airways becoming obstructed. Wade’s colleage, Ivan Magill, an Irishman originally in charge of the medical welfare of demobilised troops, enhanced the effectiveness of pain relief further with his technique of inserting the vapour directly into the windpipe.
Surgeons as well as patients benefited from these innovations. Chloroform pads often either fell off or obscured the operation site, while ether involuntarily exhaled by a patient could sometimes send a surgeon to sleep in the middle of the job. Occasionally the anaesthetic failed to obliterate the extraordinary pain of having a new face sewn on to the remaining flesh and bone, and it was sometimes necessary to hold the man down, so excruciating was the experience.
Corporal Ward Muir at the Third London General Hospital described the distress involved in talking ‘to a lad who six months ago was probably a wholesome and pleasing specimen of English youth and is now a gargoyle and a broken gargoyle at that’. Conversing was ‘an ordeal’. But the staff of the plastic surgery unit learned not to betray the horrors that confronted them. Accompanied by his hand-picked professionals, Gillies would enter the operating theatre‘head thrust forward from his slightly stooping shoulders, with the air of an artist who aspires to produce a masterpiece’. An assistant noticed that ‘all the actions of his hands were consistently gentle, accurate and deft’.
In his efforts to ‘restore beauty to the human form’, Gillies asked a good deal of his patients. The experimental and improvised surgical risks which these battered men were prepared to undertake were courageous, but the hope of having some level of normality restored to their lives was enough to sustain them.
The most daring of the new surgical techniques involved the detaching of a healthy flap of skin from another part of the body, most commonly the shoulder or the chest. This flap would then be joined to the damaged area in the expectation that healthy new tissue would grow. A young naval rating, A. B. Vicarage, had been severely burned during the Battle of Jutland: the fire had scarred all of his exposed face, leaving him without much of a nose and tightening his eyelids so he could not close them. In addition his mouth had contracted so severely after the wounds had healed that he arrived at Sidcup unable to open or close it. The acid in his saliva that dribbled out in a constant uncontrollable stream was causing dreadful sores. Even the resilient Gillies considered Vicarage’s injuries ‘appalling’.
As Gillies lifted the skin flap from Vicarage’s chest it rolled over and he had the idea to sew the grafted skin into a tube before fixing it on to the damaged part of the face. This procedure, which became known as the pedicle method, ensured that the underside of the healthy tissue was no longer open and exposed to possible infection. The tube embedded itself into the damaged skin and at the join, new tissue began to grow. Gradually Vicarage’s new face began to form from the ‘slender pink orchidaceous stalks’.
Some of Gillies’s work involved repairing the hasty, unfeeling botched jobs made on prisoners of war by German surgeons. Gillies was appalled to find a nose full of hair growing in the centre of one unfortunate man’s face because a graft on the nose had been taken from above his hairline.
Not every operation was successful. Herbert Lumley from the Royal Flying Corps, a jaunty pipe-smoking lad, was so badly woundedon his very first solo flight that although Gillies operated on him with particular urgency the skin graft would not
Without anaesthetic the operations would have been intolerable and pain-relief systems were not wholly reliable. But Rubens Wade worked out a way of delivering anaesthesia to a patient in the sitting position, reducing the risk of the airways becoming obstructed. Wade’s colleage, Ivan Magill, an Irishman originally in charge of the medical welfare of demobilised troops, enhanced the effectiveness of pain relief further with his technique of inserting the vapour directly into the windpipe.
Surgeons as well as patients benefited from these innovations. Chloroform pads often either fell off or obscured the operation site, while ether involuntarily exhaled by a patient could sometimes send a surgeon to sleep in the middle of the job. Occasionally the anaesthetic failed to obliterate the extraordinary pain of having a new face sewn on to the remaining flesh and bone, and it was sometimes necessary to hold the man down, so excruciating was the experience.
Corporal Ward Muir at the Third London General Hospital described the distress involved in talking ‘to a lad who six months ago was probably a wholesome and pleasing specimen of English youth and is now a gargoyle and a broken gargoyle at that’. Conversing was ‘an ordeal’. But the staff of the plastic surgery unit learned not to betray the horrors that confronted them. Accompanied by his hand-picked professionals, Gillies would enter the operating theatre‘head thrust forward from his slightly stooping shoulders, with the air of an artist who aspires to produce a masterpiece’. An assistant noticed that ‘all the actions of his hands were consistently gentle, accurate and deft’.
In his efforts to ‘restore beauty to the human form’, Gillies asked a good deal of his patients. The experimental and improvised surgical risks which these battered men were prepared to undertake were courageous, but the hope of having some level of normality restored to their lives was enough to sustain them.
The most daring of the new surgical techniques involved the detaching of a healthy flap of skin from another part of the body, most commonly the shoulder or the chest. This flap would then be joined to the damaged area in the expectation that healthy new tissue would grow. A young naval rating, A. B. Vicarage, had been severely burned during the Battle of Jutland: the fire had scarred all of his exposed face, leaving him without much of a nose and tightening his eyelids so he could not close them. In addition his mouth had contracted so severely after the wounds had healed that he arrived at Sidcup unable to open or close it. The acid in his saliva that dribbled out in a constant uncontrollable stream was causing dreadful sores. Even the resilient Gillies considered Vicarage’s injuries ‘appalling’.
As Gillies lifted the skin flap from Vicarage’s chest it rolled over and he had the idea to sew the grafted skin into a tube before fixing it on to the damaged part of the face. This procedure, which became known as the pedicle method, ensured that the underside of the healthy tissue was no longer open and exposed to possible infection. The tube embedded itself into the damaged skin and at the join, new tissue began to grow. Gradually Vicarage’s new face began to form from the ‘slender pink orchidaceous stalks’.
Some of Gillies’s work involved repairing the hasty, unfeeling botched jobs made on prisoners of war by German surgeons. Gillies was appalled to find a nose full of hair growing in the centre of one unfortunate man’s face because a graft on the nose had been taken from above his hairline.
Not every operation was successful. Herbert Lumley from the Royal Flying Corps, a jaunty pipe-smoking lad, was so badly woundedon his very first solo flight that although Gillies operated on him with particular urgency the skin graft would not
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