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.
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
Known as the Carrel-Dankin method
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
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.
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
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.
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."
Invented by Hugh Owen
Thomas, a Liverpool surgeon
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.
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
Many casulties had been wounded by shrapnel, bullets
and fragments that needed to be located to make
surgery faster and more effective,
The increased use of x-rays reduced the death rate from infections.
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
The main problem with transfusing blood was
that it could not be stored without the blood
clotting.
A series of linked discoveries
solved the problem of
storing blood and increasing
the number of transfusions:
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.
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.
3. A British surgeon ,Geoffrey Keynes, created
a mobile machine for storing blood which
meant to could be taken closer to the Front
Line.
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
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.
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.
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
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
Most soldiers stayed alive and fit enough to cope with the
operations because they were given blood
transfusions and saline solutions to reduce shock.
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.