Vicarage Diptych

Sailor’s Uniforms, digital embroidery, applique, digital print. 2005-2007

William Vicarage, a 20 year-old watchmaker from Swansea South Wales, suffered serious cordite burns whilst serving aboard the H.M.S. Malaya in the Battle of Jutland. His facial injuries included the loss of most of his nose and part of his ears. He also suffered severe ectropion of the lips and eyelids (where the tight scar tissue turns the inner surfaces outwards). Vicarage was admitted to the recently established plastic surgery unit at Queen Mary’s Hospital Sidcup and whilst in the care of pioneering facial surgeon Sir Harold Gillies proposed underwent life changing facial surgery. Gillies released a large ‘Masonic collar flap’ of skin from William’s chest and stitched it to the lower part of the face with connecting straps of skin known as pedicle flaps which maintained a constant, uninterrupted blood supply to the large graft.

This surgery marked a turning point in skin grafting. As the flap was raised and sutured in place on William’s face, the long parallel edges of the connecting pedicle flaps of skin curled in toward each other under tension. It is noted that when observing this, Gillies began to stitch the long edges together to form tubes to the astonishment of those present in theatre. Tubing the pedicle flaps ensured better supply of blood and reduced the chance of infection to the raw underside of the flaps.

The foundation of the tubed pedicle technique was only the first stage in the remarkable surgery Willie Vicarage underwent. Instead of returning the connecting tubed pedicles of skin to their donor site, Gillies used this additional tissue to further reconstruct other areas of William’s face. Writing about the birth of the technique, Gillies describes how he decided to use the connecting pedicles for the reconstruction of Willie’s nose by turning the tubes of skin up and onto the nasal and cheek areas. The surgery endured by William Vicarage marked a turning point in the treatment of thousands of patients undergoing reconstructive surgery.

The Vicarage Diptych describes the events and surgery William experienced including the events leading up to his injury, his treatment and extracts from his medical notes and reflections by Gillies. Stitch and embroidery feature heavily in the work, stitch being one of the methods used by Gillies in his treatment of William’s injuries. The diptych also includes burned detailing referencing the cause of the injury, particularly in reference to the severe burns to his hands. The facial garments included in the work describe part of the surgical procedure William underwent in addition to digitally embroidered illustrations of pre-operative planning from his medical record.

 

All Gillies Archives records appear courtesy of the Gillies Archives. Reproduction permission must be requested.