Artificial Siamese

In Washington last week a Negro boy and girl giggled in ignorant embarrassment because a plastic surgeon was about ready to bind them closer than wedlock. A year ago Clara Howard, 13, emptied a lapful of peanut shells into an open fire. Her apron caught fire and she was hospitalized with terrible first degree burns. When she was discharged she had no skin left on her torso, arms and neck. Scars held the flesh of her arms to the flesh of her sides. She could not turn her head because the lower part of her chin had grown to her chest.

The best kind of skin graft which grows on denuded flesh is skin taken from some other part of the same body. Clara Howard, however, cannot endure the further shock of such autogenous grafting from her unburned legs. So Professor Robert Emmet Moran of Georgetown University undertook something utterly new in restorative surgery.

On Clara's distant cousin, John Melvin Bonner, 16, who volunteered, Dr. Moran made two parallel slices from the left armpit straight down the side to the left hip. This week Dr. Moran will separate the strip of skin between the incisions from the underlying flesh and clip the long edges together to make a tube attached at one end to the boy's armpit, the other to his hip. As the bared flesh heals, new blood vessels will form in the tube of flesh --blood vessels which will nourish it during the next and more difficult stage of the operation.

This next step will make the boy and girl for a time virtual Siamese twins. Dr. Moran will cut the upper end of the tube of skin free from John's armpit and sew the end into the flesh of Clara's scarred abdomen. For five weeks the children will lie bandaged immovably together while John's blood nourishes the tube of flesh from one end until gradually--if the operation is successful--Clara's blood joins in nourishing it from the other. This it will presumably do without difficulty because John and Clara have the same blood grouping.

When the graft attaches itself to Clara, Dr. Moran will sever the tube of skin from John's hip, swing the tube across Clara's abdomen, and fix the end in her flesh. When that operation heals, Dr. Moran will perform the final stage of the graft. He will slit the sausage-like tube from end to end, spread it flat upon the girl's abdomen to attach itself soundly.

Later, as Clara grows stronger and older, plastic surgeons may take bits from this apron of skin, transplant them to other parts of her scarred body as islands from which new skin may grow and spread. Then, years hence, if all goes well, Clara Howard, with arms and head freed, will have a skin that is scarred and puckered but whole. John too will be permanently scarred but this thought did not deter him from volunteering. His mother, who takes roomers, promised to reward him with $20 and a new coat. But last week she took sick and the $20 went for doctor's bills. "Aw, that's all right, mom," said John.

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