Project Facade: Case studies

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NAME:

Sea. A.J.

RANK:

Pte.

AGE:

23

REGTL. NO:

6653181

REGT:

6th Londons

WOUNDED:

4/4/18

ADMITTED:

3/6/19 | 12/6/22

DISCHARGED:

18/5/22

NO. ON REG:

3805

ADMITTED FROM TOOTING MILITARY HOSPITAL
PARTICULARS OF WOUND OR INJURY: Gunshot wound to chin and fractured mandible. G.S.W. Face . Whole of chin and floor of mouth shot away. Tongue still present. Fractured mandible with large loss of-bone in symphysis region.

Splints fixed at Tooting Hospital, where patient had diphtheria, but recovered. 

21/8/19: OPERATION PERFORMED BY MR CHUBB
Tubing flap from chest to forearm for future use in plastic on chin

11/10/19: OPERATION PERFORMED BY MR CHUBB

Pedical Tube flap from chest to forearm freed at chest attachment and flap of required size brought up and sutured in position on chin to replace missing portion of chin. Arm held in position across chest by strapping .

27/11/19: OPERATION PERFORMED BY MR CHUBB
Pedical Tube detached from arm attachment, turned, and sutured on chin to further replace lost tissues. Both ends of the Pedical Tube are now sutured to chin.

4/2/20: OPERATION PERFORMED BY MR CHUBB (LOCAL)
Sub-lingual gland drainage .

18/3/20: OPERATION PERFORMED BY MR CHUBB
Large tubular flap made from right shoulder. Raw area partly skingrafted. No effort at tension closure. 

1/3/20:  TRANSFERRED TO MINISTRY OF PENSIONS .

1/9/20:  OPERATION PERFORMED BY MR SINCLAIR
INTRATRACHEAL ETHER ADMINISTERED BY MR WADE
Pedical Tube made from neck for use in forming lining of chin

4/2/20: OPERATION PERFORMED BY MR CHUBB
INTRATRACHEAL ETHER ADMINISTERED BY MR WADE
Distal end of Pedical Tube from neck and other Pedical Tube brought up at proceeding operation, sutured into floor of mouth to form lining for floor of mouth and chin.

25/10/20: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Proximal end of neck Pedical Tube detached and sutured to the detached end of first Pedical Tube brought up so as to lengthen latter, both to form lining of floor of mouth and chin, Distal end of covering flap detached from shoulder and sutured to neck beneath lining flaps.

L6/11/20: RECOMMENDED B.179 FOR BOARD

(Sd) A.P. Sinclair,

24/11/20: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Distal end of shoulder Pedical Tube (covering Pedical Tube) detached and resutured; owing to scarring; the lining Pedical Tubes were sutured to opened covering Pedical Tube.

16/12/20: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Bands 1 inch wide cut from margin of gap through skin and mucous membrane, and fumed up to position of lower lip, but not yet brought right across. Flaps already brought over, sutured into position to form floor of mouth, chin and lining. Lip to be completed later.

31/1/21: DISCHARGED ARMY B.179
Re-admitted to Hospital as Pensioner.

2/2/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Bands brought across to form lower lip.

10/3/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Red margins dissected from plastic lower lip and round upper lip, for 0.5 inch, and sutured on the stretch, so as to bring them together in centre of lower lip, to make good a deficiency here.

27/4/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Further plastic to improve chin - mainly excision of scars and sliding up of plastic chin flaps, (the scars were those surrounding original wound and were due to scorching,), so that plastic chin tissue is now united to normal face tissue. Enlarging of mouth at right corner.

25/5/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Enlarging of mouth at left corner.

22/6/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Enlarging of mouth at right corner.

22/7/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Further plastic to improve contour of chin.

2/8/21:  TO CONVALESCENT HOME , BURNHAM-ON-CROUCH.

23/8/21: RE-ADMITTED FROM CONVALESCENT HOME, BURNHAM-ON-CROUOH

26/8/21: OPERATION PERFORMED BY MR SINCLAIR.  (LOCAL).
Plastic to lower lip and corner of mouth.

16/12/21:
Extraction of teeth, L.A 54 :  5

5/1/22:
To have dentures made.

(Sd) T. Jackson.

16/5/22:
Having massage treatment to chin. Upper denture fitted and satisfactory. Lower denture tends to depress and stretch chin, which is not strong enough to support very much pressure.
Recommended discharge, to return in one month.

18/5/22: DISCHARGED TO HOME.

12/6/22: RE-ADMITTED FROM HOME.

31/10/22:
Has been on massage treatment for several months. Chin tending to become firm, but only strong enough to stand weight of lower denture.
No mastication possible Severe disability.
Facial disfigurement Severe.

31/10/22:
Patient fitted with dentures - partial upper. Lower of a very complicated type. There is loss of mandible from molar to molar region. Denture fills in remaining portion and also gives form to chin. Masticatory disability very severe. Patient will at intervals require lower prosthesis cleaned, this cannot be performed by the patient in a proper manner.

(Sd) . T .Jackson.

3/11/22: DISCHARGED TO HOME.

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