Rusk Rehabilitation

In July 2018, a car accident left 22-year-old Joseph DiMeo with third-degree burns covering 89 percent of his body and post-traumatic facial deformity from composite tissue loss of the face.

Additional diagnoses were severe neck contracture, bilateral partial facial paresis, respiratory failure, tracheostomy, and oral incompetence. Tissue loss had also caused vision loss and hearing impairment.

Mr. DiMeo underwent approximately 20 reconstructive surgeries, yet still suffered extensive physical deficits, such as amputated fingertips, lips, and eyelids, and severe facial scarring.

The full face and bilateral forearm transplantation took approximately 23 hours and involved a team of more than 140 healthcare professionals, led by Eduardo D. Rodriguez, MD, DDS.

Post-surgery, Mr. DiMeo spent five weeks in intensive care before being able to see his face for the first time. Dr. Rodriguez continued to monitor his progress and the many nerve and tissue grafts.

Mr. DiMeo then remained inpatient at Rusk Rehabilitation under the direction of Jeffrey M. Cohen, MD.

Rehabilitation demands extended far beyond face transplant to include new hand-based orthoses and exercises to improve hand and grip strength. The nursing team educated Mr. DiMeo on the importance of daily standing and walking, plus passive stretching to prevent contractures. Therapists also performed tissue massage to help remodel scar tissue on his forearms, hands, shoulders, and neck.

Prior to rehabilitation, Mr. DiMeo’s serial opposition, or his ability to touch digits 2 through 5 to the tip of his thumb, was significantly impaired. After extensive work on his fine motor dexterity, his grip strength markedly improved, allowing him to complete fine motor tasks independently, such as the ability to pick up a utensil.

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