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Pediatric Plastic and Reconstructive Surgery for Primary Care
Pediatric Plastic and Reconstructive Surgery
for Primary Care Pediatric Plastic and
AUTHOR EDITORS
American Academy of Pediatrics Peter J. Taub, MD, MS, FAAP, FACS, and
Section on Plastic Surgery Timothy W. King, MD, PhD, MSBE, FAAP, FACS
Reconstructive Surgery
With contributions from the leading experts in the field, Pediatric Plastic and
Reconstructive Surgery for Primary Care provides primary care pediatricians and
other health practitioners who care for children essential support on caring for
for Primary Care
children who are faced with plastic and reconstructive surgery–related issues.
Sixteen chapters with 200+ full-color photos provide superbly illustrated,
authoritative guidance on when to treat and when to wait, the timing of corrective
surgeries in pediatric patients, and surgical strategies and complications.
Nonsurgical management and brief descriptions of how corrective procedures
are performed are discussed, which is helpful to primary care pediatricians when
counseling patients and their families and conducting long-term patient follow-up.

The book includes chapters on

• Cleft Lip and Palate • Pediatric Neck Masses
• Craniosynostosis • Congenital Hand Anomalies
• Vascular Anomalies • Pediatric Burn Injury
• Congenital Ear Deformities • Skin and Soft-Tissue Lesions
• Orthognathic Surgery • Breast Anomalies

Timothy W. King, MD, PhD, MSBE, FAAP, FACS

Peter J. Taub, MD, MS, FAAP, FACS
• Pediatric Facial Fractures • Abdominal Wall Anomalies
• Eyelid Anomalies • Posterior Trunk Anomalies
• Facial Paralysis • Aesthetic Surgery in the Pediatric Patient

For other pediatric primary care resources, ISBN 978-1-61002-394-8 EDITORS

visit the American Academy of Pediatrics at 90000>
Peter J. Taub, MD, MS, FAAP, FACS
shop.aap.org.
Timothy W. King, MD, PhD, MSBE, FAAP, FACS

9 781610 023948

AAP

PPARSFPC - COVER SPREAD.indd All Pages 3/12/20 11:29 AM

Pediatric Plastic and
Reconstructive Surgery
for Primary Care

AUTHOR
American Academy of Pediatrics
Section on Plastic Surgery

EDITORS
Peter J. Taub, MD, MS, FAAP, FACS
Timothy W. King, MD, PhD, MSBE, FAAP, FACS

PedPS_FM_i-xviii.indd 1 05/03/20 11:54 AM

American Academy of Pediatrics Publishing Staff
Mary Lou White, Chief Product and Services Officer/SVP, Membership, Marketing, and Publishing
Mark Grimes, Vice President, Publishing
Heather Babiar, MS, Senior Editor, Professional/Clinical Publishing
Jason Crase, Senior Manager, Production and Editorial Services
Theresa Wiener, Production Manager, Clinical and Professional Publications
Linda Smessaert, Senior Marketing Manager, Professional Resources
Published by the American Academy of Pediatrics
345 Park Blvd
Itasca, IL 60143
Telephone: 630/626-6000
Facsimile: 847/434-8000
www.aap.org
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians,
pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety,
and well-being of infants, children, adolescents, and young adults.
The recommendations in this publication do not indicate an exclusive course of treatment or serve
as a standard of medical care. Variations, taking into account individual circumstances, may be
appropriate.
Statements and opinions expressed are those of the authors and not necessarily those of the
American Academy of Pediatrics.
Any websites, brand names, products, or manufacturers are mentioned for informational and
identification purposes only and do not imply an endorsement by the American Academy of
Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information
was current at the time of publication.
The persons whose photographs are depicted in this publication are professional models. They
have no relation to the issues discussed. Any characters they are portraying are fictional.
The publishers have made every effort to trace the copyright holders for borrowed materials. If
they have inadvertently overlooked any, they will be pleased to make the necessary arrangements
at the first opportunity.
This publication has been developed by the American Academy of Pediatrics. The contributors are
expert authorities in the field of pediatrics. No commercial involvement of any kind has been solicited
or accepted in development of the content of this publication. Disclosures: [Populate in 2020 per MG].
Every effort has been made to ensure that the drug selection and dosages set forth in this text are
in accordance with the current recommendations and practice at the time of publication. It is the
responsibility of the health care professional to check the package insert of each drug for any
change in indications or dosage and for added warnings and precautions.
Every effort is made to keep Pediatric Plastic and Reconstructive Surgery for Primary Care consistent
with the most recent advice and information available from the American Academy of Pediatrics.
Special discounts are available for bulk purchases of this publication. Email Special Sales at
[email protected] for more information.
© 2020 American Academy of Pediatrics
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or
otherwise—without prior permission from the publisher (locate title at http://ebooks.aappublications.
org and click on © Get permissions; you may also fax the permissions editor at 847/434-8780 or
email [email protected]).
Printed in the United States of America
9-434/0520 1 2 3 4 5 6 7 8 9 10
MA0962
ISBN: 978-1-61002-394-8
eISBN: 978-1-61002-395-5
Cover and publication design by LSD Design LLC
Library of Congress Control Number: 2019944456

PedPS_FM_i-xviii.indd 2 05/03/20 11:54 AM

American Academy of
Pediatrics Reviewers

Committee on Bioethics
Council on Genetics
Section on Anesthesiology and Pain Medicine
Section on Breastfeeding
Section on Cardiology and Cardiac Surgery
Section on Infectious Diseases
Section on Neonatal-Perinatal Medicine
Section on Neurological Surgery
Section on Ophthalmology
Section on Oral Health
Section on Orthopaedics
Section on Otolaryngology–Head and Neck Surgery
Section on Radiology

iii

PedPS_FM_i-xviii.indd 3 05/03/20 11:54 AM

PedPS_FM_i-xviii.indd 4 05/03/20 11:54 AM
Editors

Peter J. Taub, MD, MS, FAAP, FACS

Professor, Surgery, Pediatrics, Dentistry, and Medical Education
Division of Plastic and Reconstructive Surgery
Icahn School of Medicine at Mount Sinai
New York, NY

Timothy W. King, MD, PhD, MSBE, FAAP, FACS

Associate Professor, Departments of Surgery and Biomedical Engineering
Director of Research, Division of Plastic Surgery
Associate Program Director, Plastic Surgery Residency
University of Alabama at Birmingham
Craniofacial and Pediatric Plastic Surgery
Children’s of Alabama
Chief, Plastic Surgery Section
Birmingham VA Medical Center
Birmingham, AL

PedPS_FM_i-xviii.indd 5 05/03/20 11:54 AM

PedPS_FM_i-xviii.indd 6 05/03/20 11:54 AM
Contributors

Stephen B. Baker, MD, DDS, FAAP, FACS

Associate Professor
Chief of Craniofacial Surgery
Department of Plastic Surgery
MedStar Georgetown University Hospital
Washington, DC
Codirector of Craniofacial Program
Inova Children’s Hospital
Falls Church, VA
Chapter 5: Orthognathic Surgery

Bruce S. Bauer, MD, FAAP, FACS

Division of Plastic Surgery
Department of Surgery
The University of Chicago
Chicago, IL
Chapter 4: Congenital Ear Deformities

Michael L. Bentz, MD, FAAP, FACS

Chair, Division of Plastic and Reconstructive Surgery
Vice Chair of Clinical Affairs, Department of Surgery
Layton F. Rikkers, MD, Chair of Surgical Leadership
Professor of Surgery, Pediatrics and Neurosurgery
University of Wisconsin–Madison School of Medicine and Public Health
Madison, WI
Chapter 10: Congenital Hand Anomalies

Lisa R. David, MD, FACS

Department of Plastic and Reconstructive Surgery
Wake Forest University
Winston-Salem, NC
Chapter 2: Craniosynostosis

Claire Sanger Dillingham, DO

Associate Professor
Department of Plastic and Reconstructive Surgery
Wake Forest School of Medicine
Winston-Salem, NC
Chapter 2: Craniosynostosis

vii

PedPS_FM_i-xviii.indd 7 05/03/20 11:54 AM

viii
Contributors

Ravi K. Garg, MD
Craniofacial Fellow
Division of Plastic and Maxillofacial Surgery
Children’s Hospital Los Angeles
University of Southern California
Los Angeles, CA
Chapter 9: Pediatric Neck Masses

Warren Garner, MD
Director, LAC+USC Burn Center
Professor of Surgery, Keck School of Medicine of USC
University of Southern California
Los Angeles, CA
Chapter 11: Pediatric Burn Injury

Jesse A. Goldstein, MD
Assistant Professor, Department of Plastic Surgery
Children’s Hospital of Pittsburgh
University of Pittsburgh Medical Center
Pittsburgh, PA
Chapter 6: Pediatric Facial Fractures

Arin K. Greene, MD, MMSc

Associate Professor of Surgery
Harvard Medical School
Department of Plastic and Oral Surgery
Vascular Anomalies Center
Boston Children’s Hospital
Boston, MA
Chapter 3: Vascular Anomalies

Jacqueline S. Israel, MD
Integrated Plastic Surgery Resident
Division of Plastic Surgery
University of Wisconsin–Madison Department of Surgery
Madison, WI
Chapter 14: Abdominal Wall Anomalies

PedPS_FM_i-xviii.indd 8 05/03/20 11:54 AM

ix
Contributors

Timothy W. King, MD, PhD, MSBE, FAAP, FACS

Associate Professor, Departments of Surgery and Biomedical Engineering
Director of Research, Division of Plastic Surgery
Associate Program Director, Plastic Surgery Residency
University of Alabama at Birmingham
Craniofacial and Pediatric Plastic Surgery
Children’s of Alabama
Chief, Plastic Surgery Section
Birmingham VA Medical Center
Birmingham, AL
Chapter 4: Congenital Ear Deformities
Chapter 14: Abdominal Wall Anomalies

Brian I. Labow, MD, FAAP, FACS

Associate Professor of Surgery, Harvard Medical School
Department of Plastic and Oral Surgery
Boston Children’s Hospital
Boston, MA
Chapter 13: Breast Anomalies

Joseph E. Losee, MD, FAAP, FACS

Ross H. Musgrave Endowed Chair in Pediatric Plastic Surgery
Associate Dean for Faculty Affairs, University of Pittsburgh School of
Medicine
Professor and Executive Vice Chair, Department of Plastic Surgery, University
of Pittsburgh Medical Center
Division Chief, Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh
Pittsburgh, PA
Chapter 6: Pediatric Facial Fractures

Frederick Lukash, MD, FAAP, FACS

Long Island Plastic Surgical Group
New York, NY
Chapter 16: Aesthetic Surgery in the Pediatric Patient

Donald R. Mackay, MD, FAAP, FACS

William P. Graham III Professor of Plastic Surgery
Professor of Surgery and Pediatrics
Vice Chair, Department of Surgery
Penn State College of Medicine
Hershey, PA
Chapter 15: Posterior Trunk Anomalies

PedPS_FM_i-xviii.indd 9 05/03/20 11:54 AM

x
Contributors

Brad T. Morrow, MD
Plastic Surgeon
Marshfield Children’s Hospital
Marshfield Clinic Health System
Marshfield, WI
Chapter 15: Posterior Trunk Anomalies

Laura C. Nuzzi, BA
Clinical Research Specialist
Department of Plastic and Oral Surgery
Boston Children’s Hospital
Harvard Medical School
Boston, MA
Chapter 13: Breast Anomalies

Jordan P. Steinberg, MD, PhD, FAAP, FACS

Assistant Professor, Department of Plastic Surgery
Johns Hopkins University School of Medicine
Pediatric Plastic Surgery
Johns Hopkins Children’s Center
Baltimore, MD
Chapter 12: Skin and Soft-Tissue Lesions

Peter J. Taub, MD, MS, FAAP, FACS

Professor, Surgery, Pediatrics, Dentistry, and Medical Education
Division of Plastic and Reconstructive Surgery
Icahn School of Medicine at Mount Sinai
New York, NY
Chapter 1: Cleft Lip and Palate
Chapter 7: Eyelid Anomalies

Mark M. Urata, MD, DDS

Chair and Chief, Division of Plastic and Reconstructive Surgery
Keck School of Medicine of USC
Division Head, Plastic and Maxillofacial Surgery
Children’s Hospital Los Angeles
Chair, Division of Oral and Maxillofacial Surgery
Herman Ostrow School of Dentistry of USC
Los Angeles, CA
Chapter 9: Pediatric Neck Masses

PedPS_FM_i-xviii.indd 10 05/03/20 11:54 AM

xi
Contributors

Haig Yenikomshian, MD
Assistant Professor, Clinical Surgery
Keck School of Medicine of USC
University of Southern California
Los Angeles, CA
Chapter 11: Pediatric Burn Injury

Ronald M. Zuker, MD, FRCSC, FACS, FRCSEd(Hon)

Professor of Surgery
University of Toronto
Consultant Staff Surgeon
The Hospital for Sick Children (SickKids)
Toronto, Ontario, Canada
Chapter 8: Facial Paralysis

PedPS_FM_i-xviii.indd 11 05/03/20 11:54 AM

PedPS_FM_i-xviii.indd 12 05/03/20 11:54 AM
Contents

Acknowledgments ..................................................................... xv
Preface ......................................................................................xvii

Chapter 1: Cleft Lip and Palate .....................................................................1

Peter J. Taub, MD, MS, FAAP, FACS
Chapter 2: Craniosynostosis........................................................................ 17
Lisa R. David, MD, FACS, and Claire Sanger
Dillingham, DO
Chapter 3: Vascular Anomalies...................................................................39
Arin K. Greene, MD, MMSc
Chapter 4: Congenital Ear Deformities....................................................... 51
Bruce S. Bauer, MD, FAAP, FACS, and
Timothy W. King, MD, PhD, MSBE, FAAP, FACS
Chapter 5: Orthognathic Surgery................................................................67
Stephen B. Baker, MD, DDS, FAAP, FACS
Chapter 6: Pediatric Facial Fractures.......................................................... 81
Jesse A. Goldstein, MD, and Joseph E. Losee,
MD, FAAP, FACS
Chapter 7: Eyelid Anomalies...................................................................... 105
Peter J. Taub, MD, MS, FAAP, FACS
Chapter 8: Facial Paralysis......................................................................... 113
Ronald M. Zuker, MD, FRCSC, FACS, FRCSEd(Hon)
Chapter 9: Pediatric Neck Masses..............................................................129
Ravi K. Garg, MD, and Mark M. Urata, MD, DDS
Chapter 10: Congenital Hand Anomalies................................................... 139
Michael L. Bentz, MD, FAAP, FACS
Chapter 11: Pediatric Burn Injury............................................................... 153
Haig Yenikomshian, MD, and Warren Garner, MD
Chapter 12: Skin and Soft-Tissue Lesions.................................................... 165
Jordan P. Steinberg, MD, PhD, FAAP, FACS

xiii

PedPS_FM_i-xviii.indd 13 05/03/20 11:54 AM

xiv
Contents

Chapter 13: Breast Anomalies...................................................................... 183

Laura C. Nuzzi, BA, and Brian I. Labow,
MD, FAAP, FACS
Chapter 14: Abdominal Wall Anomalies....................................................199
Jacqueline S. Israel, MD, and Timothy W. King,
MD, PhD, MSBE, FAAP, FACS
Chapter 15: Posterior Trunk Anomalies..................................................... 213
Brad T. Morrow, MD, and Donald R. Mackay,
MD, FAAP, FACS
Chapter 16: Aesthetic Surgery in the Pediatric Patient..............................229
Frederick Lukash, MD, FAAP, FACS

Index..........................................................................................239

PedPS_FM_i-xviii.indd 14 05/03/20 11:54 AM

Other documents randomly have
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He näkivät nyt, vaikkeivät he tähän asti olleet sitä
huomanneetkaan, että pitäjäntuvalta oli siroitettu kuusenhakoja aina
talon päärakennuksen eteen saakka, ja oven molemmin puolin oli
pystytetty kuusia. Siellä oli siis ruumis talossa. Mutta sittenkään he
eivät voineet käsittää, miten he eivät olleet kuulleet mitään
kuolemantapauksesta sellaisessa talossa. Eikä ikkunoissa myöskään
ollut hursteja, niinkuin tulee olla, kun kuolema käy talossa.

Nyt eteisen ovet avattiin selkosen selälleen ja ulos tuli sittenkin

ruumissaatto. Nolin August astui ensimäisenä surusauva kädessä, ja
hänen jäljessään kantajat arkkuineen.

Saattoon yhtyi sitten koko ihmisjoukko, joka oli odottanut kirkon

edustalla. Tämän vainajan vuoksi he siis olivat saapuneet kirkolle.

He kantoivat arkun pitäjäntuvan edustalle ja laskivat sen toisen

arkun oikealle puolelle. Nolin August siirsi pukkeja, niin että
molemmat arkut joutuivat aivan rinnakkain.

Myöhempi arkku ei ollut yhtä uusi ja kiiltävä kuin Katrinan. Se oli

varmaan saanut monta sadekuuroa kestää jo ennen tätä päivää. Sitä
oli varomattomasti käsitelty, niin että se oli saanut naarmuja ja
kolauksia.

Kaikki askedalilaiset vetivät syvältä henkeään, sillä nyt he alkoivat

ymmärtää. Tuossa arkussa ei maannut ketään Nolin Augustin
sukulaista. Ei minkään suurmiehen vuoksi noin paljon ihmisiä ollut
saapunut kirkolle.

Nyt kaikkien katseet kulkivat Klara Gullaan, nähdäkseen

ymmärsikö hänkin, mistä oli kysymys. Ja hänestä saattoikin selvästi
huomata, että hänkin sen ymmärsi.
Hän oli seisonut kalpeana ja itkettyneenä kaiken aikaa äitinsä
arkun vieressä, ja kun hän nyt tunsi toisen arkun, jota he kantoivat
Nolin talosta, näytti tämä iloinen yllätys saattavan hänet aivan pois
suunniltaan, niinkuin voi käydä, kun vihdoin saa sen, mitä kauan on
odottanut. Mutta hän rauhoittui pian. Hän hymyili surun voittoisesti
ja siveli pari kertaa hiljaa arkun kantta. »Nyt sinun on oikein hyvä
olla», näytti hän aikovan sanoa kuolleelle äidillensä.

Nolin August astui Klara Gullan luo ja otti häntä kädestä.

»Ei suinkaan Klara Gullalla ole mitään sitä vastaan, että

järjestimme asiat täten», sanoi hän. »Me löysimme hänet vasta
perjantaina. Arvelin, että se täten olisi Klara Gullalle helpompi.»

Klara Gulla vastasi vain pari sanaa. Ja huulet vapisivat, niin että
niitä tuskin saattoi kuulla.

»Kiitos! Hyvähän se on. Tiedänhän, ettei hän tule minun, vaan

äidin luokse.»

»Hän tulee teidän kummankin luo, sen Klara Gulla saa nähdä»,
sanoi
Nolin August.

Fallan vanha emäntä, joka oli kahdeksankymmenen vuoden vanha

ja monien surujen murtama, oli myös tullut kirkolle kunnioittamaan
Katrinaa, joka niin kauan oli palvellut häntä uskollisesti ja ollut hänen
hyvä ystävänsä. Hän oli ottanut mukaansa keisarikepin ja hatun,
jotka olivat annetut hänelle takaisin. Hän aikoi laskea ne hautaan
Katrinan viereen. Hän arveli, että Katrina kernaasti tahtoisi saada
läheisyyteensä jotain, mikä muistutti Jannea.
Nyt Klara Gulla astui hänen luokseen ja pyysi saada keisarikalut, ja
sitten hän asetti pitkän kepin pystyyn Jannen arkkua vasten ja hatun
sen päähän. Väki ymmärsi hänen ajattelevan sitä, ettei hän ollut
antanut Jannen kulkea keisarikoreudessaan palattuansa kotiin. Hän
tahtoi hyvittää sen verran kuin hän saattoi. Paljon ei kuolleen hyväksi
voi tehdä.

Tuskin oli keppi pystytetty arkun viereen, kun kirkon kellot alkoivat
soida, ja samalla tulivat pappi ja lukkari ja suntio sakaristosta ja
asettuivat saaton etunenään.

Sade virtasi kuurottain sinä päivänä, ja kaikeksi onneksi se piti

hiukan väliä, kun seurakunta järjestyi riviin, ensin miehet ja sitten
vaimoväki, ja valmistui saattamaan näitä kahta vanhusta hautaan.

Ne, jotka asettuivat saattoon, näyttivät ikäänkuin itsekin

ihmettelevän sitä, että olivat täällä mukana. Sillä eivät he juuri
mitään surua tunteneet, eivätkä liioin tahtoneet osoittaa
kunnioitustaan kummallekaan vainajalle. Asian laita oli vain sellainen,
että kun tieto oli levinnyt pitkin pitäjää, että Skrolyckan Janne oli
löytynyt juuri sopivaan aikaan, jotta hänet voitaisiin haudata yhteen
hautaan kuin Katrinakin, oli siinä kaikkien mielestä ollut jotain
kaunista ja ihmeellistä, ja he olivat halunneet nähdä, miten kuolema
yhdistäisi jälleen nuo vanhat aviopuolisot.

Eihän kukaan voinut aavistaa, että niin monet ajattelisivat aivan

samoin. Nyt oli nostettu melkein liiaksi melua kahdesta niin köyhästä
ja alhaisesta ihmisestä. Ihmiset katsoivat toisiinsa ja olivat hiukan
häpeissänsä, mutta kun he nyt kerran olivat siellä, niin oli myös
pakko lähteä hautausmaalle.
Täytyihän heidän itsekseen hiukan hymyilläkin koko asialle, kun he
tulivat ajatelleeksi, että tämä olisi Portugallian keisarille ollutkin hyvin
mieleen. Kahta surusauvaa, sillä toinen oli seurannut Askedalista
mukana, kannettiin hänen ja Katrinan arkun edellä ja melkein koko
pitäjä seurasi mukana saattojoukossa. Sen paremmin ei olisi voinut
käydä, vaikka hän itse olisi saanut olla mukana järjestämässä.

Ja kukapa tietää, vaikka se olisi ollutkin hänen tointaan. Hän oli

tullut niin kummalliseksi kuolemansa jälkeen, tuo vanha keisari. Hän
oli varmaan jotain sillä tarkoittanut, että oli antanut tyttären niin
kauan odottaa itseänsä, ja aivan varmasti oli joku tarkoitus siinäkin,
että hän oli tullut syvyydestä esiin juuri parhaaseen aikaan.

Kun he kaikki olivat saapuneet leveän haudan partaalle ja arkut

olivat lasketut maan poveen, alkoi lukkari laulaa: »Ma kuljen kohti
kuolemaa ‒ ‒ ‒»

Lukkari Svartling oli tähän aikaan vanha mies. Hänen laulunsa toi
Klara Gullan mieleen toisen vanhan miehen, jonka laulua hän ei ollut
tahtonut kuunnella.

Tuo ajatus tuotti hänelle suurta tuskaa. Hän puristi kädet

sydäntään vastaan ja sulki silmänsä, jotta ne eivät ilmaisisi, miten
syvästi hän kärsi.

Hänen seisoessaan siinä silmät ummessa hän näki edessään

isänsä kasvot, sellaisina kuin ne Klara Gullan nuorena ollessa olivat
olleet ja jolloin isä ja tytär olivat niin hyviä ystäviä.

Hän näki ne sellaisina kuin ne olivat eräänä aamuna kovan

lumituiskun jälkeen, jolloin tiet olivat ummessa ja isän oli täytynyt
kantaa hänet kirkkoon.
Hän näki ne edessään sellaisina, kuin ne olivat sinä päivänä, jolloin
Klara Gulla meni kirkolle punaisessa leningissään. Ei kukaan ollut
näyttänyt niin onnelliselta ja hyvältä kuin Janne sillä kertaa. Sitten
Jannen onni oli sammunut, eikä Klara Gullakaan ollut enää oikein
tyytyväinen.

Klara Gulla koetti pysyttää silmiensä edessä nämä kasvot. Ne

tekivät hänelle niin hyvää. Katsellessaan niitä nousi voimakas
hellyyden aalto hänen rinnastansa.

Nuo kasvot tahtoivat hänelle vain hyvää. Niitä ei tarvinnut lainkaan

pelätä.

Sehän oli vain vanha, kiltti Skrolyckan Janne. Ei hän tahtonut

tuomita Klara Gullaa, ei hän tahtonut saattaa onnettomuutta ja
rangaistusta ainoalle lapselleen.

Klara Gulla tuli niin ihmeellisen rauhalliseksi. Hän oli tullut keskelle
rakkauden maailmaa, nyt kun hän saattoi nähdä isänsä sellaisena
kuin hän oli ollut ennen. Mitenkä hän saattoi olettaa, että isä vihaisi
häntä? Hän tahtoi vain antaa anteeksi.

Minne ikänä Klara Gulla meni ja mitä ikänä hän teki, siellä isäkin
tahtoi olla ja suojella häntä. Ei hän pyytänyt mitään muuta.

Vieläkin kerran Klara Gulla tunsi suuren hellyydentunteen

kohoavan sydämestään kuin valtavan aallon ja täyttävän koko hänen
olentonsa. Ja samalla hän tiesi, että kaikki oli hyvin. Nyt hän ja isä
olivat yksi, niinkuin ennenkin. Nyt, kun Klara Gulla rakasti häntä, ei
mitään sovitettavaa enää ollut.
Klara Gulla heräsi ikäänkuin unesta. Hänen katsellessaan isänsä
hyviä kasvoja oli pappi suorittanut hautauksen. Ja nyt hän lausui pari
sanaa kokoontuneelle kansalle. Hän kiitti heitä, että he olivat tulleet
niin lukuisin joukoin näihin hautajaisiin. Mies, joka täällä oli vihitty
lepoon, ei ollut suuri eikä ylhäinen, mutta ei kellään koko
paikkakunnalla ollut niin lämmintä ja rikasta sydäntä kuin hänellä.

Sitten hän lausui myös pari sanaa Klara Gullalle. Hän oli saanut
osakseen suurempaa rakkautta vanhemmiltaan kuin kukaan muu
hänen tietääksensä, ja sellaisen rakkauden täytyi kääntyä
siunaukseksi.

Kun pappi sanoi sen, käänsivät kaikki katseensa Klara Gullaan ja

he ihmettelivät sitä näkyä, mikä heitä nyt kohtasi.

Siinä Skrolyckan Klara Fina Gulleborg, joka oli saanut nimensä itse
auringon mukaan, seisoi vanhempiensa haudalla ja hänen kasvonsa
loistivat ikäänkuin ne olisivat olleet kirkastuneet.

Hän oli yhtä kaunis kuin sinä sunnuntaina, jolloin hän tuli kirkolle
punaisessa leningissään, jollei vielä paljoa kauniimpikin.
*** END OF THE PROJECT GUTENBERG EBOOK PORTUGALLIAN
KEISARI ***

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