” We dropped the stretcher in front of a man in uniform, a fireman, without a doubt. (…) He looked at me and he almost screamed : it’s a war injury ! The word has exploded and resonated like an echo, an intimate and yet foreign, an echo caused by a story coming into my life without me belong. I was a victim of the war between Bastille and Republic. “This is the way that Philippe Lançon tells in his book The Flap what he has heard, just after having been the victim of the attack in the premises of Charlie Hebdo.

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one Hundred years after the Great War and maxillofacial surgeons continue to face the ” broken faces “. They are less often due to road accidents (the port of the safety belt protects the faces), but can be caused by various injuries, diseases (including cancers), birth defects, or even attempts of suicide by firearm. In order to raise awareness of this specialty, the French Association for the development of dentistry organizes a photo exhibition in Paris*, ” Re-Figuration “, and launches an information campaign.

Twelve years of schooling necessary

The maxillo-facial surgery, which is today exercised by 1 100 specialists very unevenly distributed on the national territory, does not attract the spotlight only occasionally, regret those who practice it. This was the case in November 2005, when professor Bernard Devauchelle and his team take to the university hospital of Amiens, the first transplant of face in the world on Isabe lle Dinoire, a patient mauled by her dog. If “the indication for surgery was a fabulous boldness, the clinical situation had not had it, nothing exceptional,” says professor Patrick Goudot, head of department at the Pitié-Salpêtrière hospital, AP-HP and president of the national Council of professional stomatology, oral surgery and maxillo-facial surgery, in a folder produced on the occasion of this exhibition.

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We learned that 12 years of education are needed to train such a specialist. A comprehensive approach that will allow him to take care of all the face, the bones as soft tissue, since the tip of the hair up to the base of the neck and from the ears up to the tip of the nose. “It is this that also makes it fit to carry out the interventions necessary to collect on a fibula, a scapula, or iliac crest flaps free it to accompany the latter on a deal to rebuild a jaw, or the skin of an inner thigh or forearm to restore the mucous membrane of the mouth, and to take care of all the post-operative phase “, can we read. To “re-appear” a human being, it must both manage of the bones and their joints, tissues, muscles and teeth, know how to repair a nerve, worrying about micro-vascularisation and capacity of the respiratory tract. A meticulous work which allows not only to repair the face, but also to rebuild the image and restore the identity.

* prior to December 14, 2018 in the chapelle Saint-Louis de la Pitié-Salpêtrière, 83, boulevard de l’hôpital, Paris 13e.

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