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Medical care on the Western Front

Treating wounds and infection
1. Aseptic operating theatres were not enough to stop infections. By the time that many soldiers had reached the theatres, many wounds were already infected due to fragments of muddy clothing or soil. Instead, chemicals such as carbolic acid and hyrdrogen peroxide were used to kill the bacteria.
  1. A more effective solution was concocted by two doctors, Alexis Carell and Henry Dankin. They used a system of tubes to keep a chemical solution flowing through the wound. This would fight the infection or stopped it from developing. As it was continous, it reduced the number of amputations due to infection
    1. Known as the Carrel-Dankin method
2. Second major development was carrying out deeper surgery (cutting away more tissue around the wound). In 1914, surgeons still used Boer War methods of surgery- removing a bullet and sewing up the wound
  1. As a result, many infections remained in the body because the deadly tissue had not been cut away and soliders', who had been expected to recover from their injury, died. Therefore, by 1915, more extensive surgery was used.
    1. This type of surgery created larger wounds but much reduced the chances of gas gangrene and tetanus developing ; the main causes of amputations and deaths
The Thomas Splint
1. Soldiers who has their femur broken by gunfire died in huge numbers . Henry Gray, the Consulting Surgeon to the British 3rd Army said that about 80% of soldiers injured like this in 1914 and 1915 died.
  1. Reduced the death rate from 80% to 20%. Described by Ambrose Lockwood a RAC surgeon in 1919 as, " the most important agent of all... in combatting shock and in saving life and limbs."
2. Invented by Hugh Owen Thomas, a Liverpool surgeon
  1. Prevented the bones from grinding on each other (would cause considerable blood loss and weaken the patient). To do this, the leg was pulled lengthways.
    1. From 1916, all regimental medical officers were taught how to use it so it could be used as near to the Front Line as possible. This meant when the soliders reached the Casualty Clearing Station, they were fit enough to be operated on as they had not lost as much blood.
Mobile X-ray machines
1. Many casulties had been wounded by shrapnel, bullets and fragments that needed to be located to make surgery faster and more effective,
  1. The increased use of x-rays reduced the death rate from infections.
2. In January 1915, there were only 2 X-ray vehicles in the British Army. However, due to government actions, by 1916, most CCS, as well as all hospitals, had X-ray equipment with additional X-ray lorries attached to groups of CCS
Blood transfusions and the storage of blood
1. The main problem with transfusing blood was that it could not be stored without the blood clotting.
2. A series of linked discoveries solved the problem of storing blood and increasing the number of transfusions:
  1. 1. An American scientist, Richard Lewisohn, discovered that sodium citrate could be added to blood to prevent it from clotting. However this stored blood deteriorated quickly and had to be used soon after being donated.
    1. 2. Scientist found that blood could be stored in refrigerated conditions. Adding a citrate glucose solution to the blood allowed to to be stored for several days. This led to the first blood banks being created ahead of a major attack so it could be used for the wounded.
      1. 3. A British surgeon ,Geoffrey Keynes, created a mobile machine for storing blood which meant to could be taken closer to the Front Line.
3. The first blood depot was created before the Battle of Cambrai in 1917. Group O had been collected because it could be given to anyone safely.
Plastic surgery
1. The solving of the problems of the danger of infection and the absence of effective anaesthetics meant that surgeons could make considerable progress . One major improvement in technique was the use of skin grafts; taking skin from another part of the patient's body and grafting it onto the area of the wound.
2. Surgeons carried out over 11,000 plastic surgery operations. By November 1915, 7 hospitals in France had specialist areas to deal with plastic surgery-needing wounds.
3. Harold Gillies was a New Zealand surgeon who served with the RAMC throughout the war and became known as the 'father of plastic surgery'. He persuaded the army's chief surgeon that a specialist facial injury care was needed in England for the wounded. As a result, the Queen's Hospital was opened up in Kent, 1917.
Brain surgery
1. The number of head and brain wounds in 1914 caused surgeons to try new ideas. One of which was putting rubber bands around the head to put pressure of the wounds and so reduce blood loss
2. Most soldiers stayed alive and fit enough to cope with the operations because they were given blood transfusions and saline solutions to reduce shock.
3. The use of X-rays meant that surgeons were able to locate, identify and remove bullet and shell fragments. Surgeon Harvey Cushing invented a surgical magnet to extract bullets from head wounds.

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Medical care on the Western Front

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	Created by Anna-Marie McGhee over 3 years ago