Harold Gillies: The Face of a Hero
His Work
Queens Hospital
Map of Queens Hospital
Source: British Association of Plastic, Reconstructive and Aesthetic Surgeons
"Gillies established The Queen’s Hospital at Frognal House in Sidcup in 1917. It was the world’s first ever hospital dedicated to the treatment of facial injuries... The aim of The Queen’s Hospital was to reconstruct wounded men’s faces as fully as possible, so that they could hopefully lead a normal life. Many patients lived in fear of what their loved ones would say when they saw how badly disfigured they were..."
Source: National Army Museum
Gillies purposefully kept no mirrors in the hospital in consideration for the men.
"We had two night watchmen, both wounded very badly in WW1. They had gone through facial reconstructive procedures after the War but the price they paid for their Country was unbelievable. They were so disfigured, only night work was possible, they never looked us in the face, but we (the nurses) began to feel comfortable with them, feed them a sandwich and a cup of tea on a cold night... Stan the one I knew best told me he had never had a family, never been to a dance, never enjoyed a girlfriend even before the war."
~ Nurse at Queen Mary's Hospital Sidcup - 1950s
The Tube Pedicle
"On October 3, 1917, an Able Seaman by the name of Vicarage was wheeled into the operating theatre at Queen Mary’s Hospital. All the skin had been burnt off his face in a cordite explosion on H.M.S. 'Malaya'. "
~ CJ Williams, NZEDGE
"This poor sailor was rendered hideously repulsive and well-nigh incapacitated by terrible burns received in the battle of Jutland.
How a man can survive such an appalling burn is difficult to imagine, until one has met one of these survivors from fire, and realised the unquenchable optimism which carries them through almost anything."
~Harold Gillies
Vicarage was a breakthrough for Gillies. He had now found a way to successfully rebuild facial structure using the patient's own body. This paved the way to hundreds more successful surgeries.
Vicarage and the tube pedicle,
Source: Gillies Archives of Plastic Surgery
How?
"Cutting the skin off the patient’s chest, he made a scroll large enough to cover his face. Adequate blood supply was ensured by leaving the lower ends of the scroll attached to the chest. Apertures were then cut for the mouth and eyes and when it was stitched into position, it was given added blood supply from two thinner strips of skin raised from the shoulders with the free ends grafted on to the new face. While raising the skin from the patient’s shoulders Gillies noticed its tendency to curl inwards. Then came a flash of inspiration:
'If I stitched the edges of those flaps together, might I not create a tube of living tissue which would increase the blood supply to grafts, close them to infection, and be far less liable to contract or degenerate as the older methods were?' … 'another needle was threaded and, in an astonished silence, I began to stitch the flaps into tubes'.
~Harold Gillies
This innovation proved extremely successful and within a few weeks, tubes were seen sprouting from scores of his patients. The pedicle tube simplified grafting and made it more certain that a shattered face would be recognisable again. More importantly, the patient could return to society with some semblance of normalcy. Looking back, Gillies stated that it was “a major breakthrough, which I had good reason to be proud of.' "
Source: CJ Williams, NZEDGE
Created along with many other casts and models in 1917 by Henry Pickerell, the wax model pictured above was used to teach the new methods of reconstruction to surgeons.
Picture is courtesy of the National Army Museum
Skin Grafts
Before
After
Walter Yeo was one of the first plastic surgeries that Gillies did using a skin grafting technique. This was done by releasing a large flap of skin, called a pedicle, from a place near the wound. Since it's still connected to the body, the skin flap would be swung over to the site of injury. The maintenance of the physical connection was critical, as it ensured a proper blood supply to the skin, which increased the chance of acceptance of the graft by the body.
Source of the photo: The Collection of British Association of Plastic, Reconstructive and Aesthetic Surgeons
‘It was Gillies’ intention to take a strip of skin from my forehead and after lifting it to twist it downwards over the site of my nose to be, and at the same time to get some cartilage from me elsewhere to form the bridge of my nose.’
~ Captain Budd, wounded in a shell blast - 1918
Documented Photos
Before
After
"Lieutenant William Spreckley, who was admitted to the Queen's Hospital, Sidcup, aon January 30, 1917. Gillies was alarmed after an eatly procedure left Spreckley with a nose like an 'anteater's snout'."
Source: The Facemaker by Lindsey Fitzharris, Archives of the Royal College of Surgeons of England
Before
After
"Private R. W. D. Seymour, aka "Big Bob," whose nose was partially severed on the first day of the Battle of the Somme. He eventually became Gillies's private secretary,"
Source: The Facemaker by Lindsey Fitzharris, The Archives of the Royal College of Surgeons of England
Before
After
"Sergeant Sidney Beldam, who was wounded during the Battle of Passchendaele. He remained where he fell for three days before being rescued. Gillies had to reopen a hastily stitched wound in order to rebuild Beldam's face-- a process that took several years,"
Source: The Facemaker by Lindsey Fitzharris, The Archives of the Royal College of Surgeons of England
Harold Gillies (second from left) in an operating theater in 1924. He was operating on Danish soldiers that were wounded because of the explosion of the cruiser Geysir in 1923.
Source: The Facemaker - Lindsey Fitzharris, gallica.bnf.fr / Bibliotheque notionale de Fracnce