Surgery - THE IMPACT OF WAR

Question	Answer
Positive Impact.	+ Surgeons provided treatment to wounded soldiers on the Front Line, and so gained a great deal of experience in a wide range of injuries. * In this way, the role of war actually accelerated training.
Approximately how many British casualties were there in WW1?	* Two million.
Positive impact.	+ New discoveries of surgical techniques surfaced through the introduction of explosive weaponry in battles. e.g. Soldiers often suffered infection when shrapnel and clothing fragments entered a wound. This led surgeons to discover that cutting away infected tissue and soaking a wound with a saline (salt) solution was an effective method. * Carol-Daken solution, a new antiseptic, was developed.
Positive impact.	+ Some surgeons made the first proper attempts at brain surgery. e.g. Tying rubber bands around a patient's head to control bleeding, using magnets to remove shrapnel, etc.
Positive impact.	+ At the beginning of WW1, Harold Gillies asked for permission to set up the first plastic surgery unit (reserved only for the British Army). This gave hope to many sufferers of physical disfigurements.
Positive impact.	+ WW1 brought advances in prosthetic limbs, including the use of metal alloys.
Between 1914 and 1921, how many British soldiers lost a limb?	* Over 41,000.
Positive impact.	+ There was a new focus on developing the storage of blood; most importantly for emergency transfusions.
Positive impact.	+ The 'triage system' was introduced, where treatment was prioritised for patients with the most serious injuries.
Negative impact.	- Being forced to treat soldiers on the Front Line, in the midst of conflict, proved incredibly difficult. Such large numbers of injuries placed many surgeons under immense pressure, causing panic that led to drastic decisions being made; particularly with amputations.
Negative impact.	- Antibiotics had not yet been developed (Penicillin, 1944), and so surgeons couldn't deal with serious infection.
Negative impact.	- Early attempts at brain surgery were dangerous, but desperation fueled by the large numbers of head injuries urged surgeons to make many risky surgical attempts, even with a lack of understanding.
Negative impact.	- Methods of plastic surgery were underdeveloped due to a lack of surgical knowledge in this field. Surgeons were also trained quickly, and so were often far less experienced then they should have been to be exposed to such extensive injuries. Some patients may have been left further disfigured, or even killed altogether.
Negative impact.	- There were long waiting lists for prosthetic limb fittings, as patients needed physiotherapy to adapt to these changes.
Negative impacts.	- Difficult conditions meant that operations being carried out under antiseptic / aseptic techniques were impossible (nothing was clean on a battlefield). Also, a lack of equipment and operating theatres / hospitals created unfamiliar conditions for surgeons to operate in.
Negative impacts.	- War meant that trained doctors were often drafted into medical and armed services, so research at home was interrupted. This created delays for new potentially crucial developments with a reduced workforce and a lack of funding (funds were diverted into warfare).
Who was Harold Gillies?	A New Zealand doctor, interested in developing plastic surgery.
When did Gillies ask permission to set up a plastic surgery unit in the British Army?	1915.
How important was the hospital Gillies helped establish in Sidcup, 1917?	It was a major medical unit, with approximately 1,000 beds.
Where did Gillies learn his ideas for plastic surgery?	From French (Morestin) and German surgeons.
What was the 'pedicle tube'?	A narrow skin layer lifted from the body and stitched into a tube at one end, with the other end still attached to the body so that blood could continue to circulate through healthy skin. Once the tube had grown long enough, the free end was attached to the new site. One the skin graft was properly in place, the pedicle tube could be cut free.
What other injuries did Gillies also treat?	Burn victims. These people received skin grafts.

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Surgery - THE IMPACT OF WAR

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	Created by Chloe Fairbrother over 9 years ago