Impact of World War One on Medicine and Surgery

World War One (1914-1918) had a profound impact on medical treatment and surgical techniques. The brutal nature of the war, with millions of soldiers suffering from injuries caused by shrapnel, machine guns, and shell fire, presented numerous challenges for medical practitioners. The high number of wounded soldiers provided surgeons with the opportunity to innovate and develop new treatments that would go on to shape the future of medicine.

Plastic Surgery and Facial Reconstruction

One of the most significant medical advancements during World War One was the development of plastic surgery, particularly in the field of facial reconstruction. Many soldiers sustained severe facial injuries, often from explosions or gunfire, which left them disfigured. The psychological and emotional toll of these injuries made it essential to not only treat the physical wounds but also to support the soldiers' mental health and rehabilitation.

Harold Gillies

Dr. Harold Gillies, a New Zealand doctor, became a pioneering figure in the field of plastic surgery. Initially working on the front lines as a surgeon, he was later transferred to Queen Mary’s Hospital in Sidcup, London, in 1917, where he set up a specialised ward to treat soldiers with facial injuries. Gillies was instrumental in the development of skin grafting techniques. One of his key innovations involved the use of a pedicle graft, in which a patch of skin was moved from one part of the body to another, still attached by its veins. This method ensured that the transplanted skin retained a blood supply, enabling it to heal effectively when attached to a different area of the face. Gillies' work in facial reconstruction helped thousands of soldiers regain their appearance and self-confidence, marking a major breakthrough in plastic surgery.

Francis Derwent Wood

Another important contributor to the field of facial reconstruction was Francis Derwent Wood, a sculptor turned medical practitioner. Wood worked in hospitals across England, where he used his skills in sculpture to create lifelike facial masks for soldiers who had suffered disfiguring facial injuries. These masks not only helped to restore the soldiers’ appearances but also supported their mental well-being by aiding their reintegration into society. The masks allowed the soldiers to face the public without shame, and for many, this was a crucial part of their psychological recovery after the war.

New Medical Treatments and Innovations

The severity and scale of the injuries sustained during World War One led to several important developments in medical treatments and surgical practices. Some of the key innovations include:

Blood Transfusions

The discovery of blood groups by Karl Landsteiner in 1901 had made blood transfusions a possibility, but the practice faced significant limitations during the early years of the war, as blood could not be stored. In response to this challenge, scientists developed a method for preserving blood. By adding sodium citrate to blood, it could be prevented from clotting, allowing it to be stored for short periods. This innovation made blood transfusions far more practical and saved countless lives during the war.

X-rays

The development of X-ray technology played a crucial role in improving the effectiveness of surgery during World War One. Although X-rays were invented in 1895 by Wilhelm Röntgen, it was the work of Marie Curie and her husband Pierre Curie that advanced the use of X-rays in field hospitals during the war. Marie Curie is credited with organising the delivery of 200 mobile X-ray units to French military hospitals, along with 20 mobile X-ray vehicles (nicknamed "petites Curies" or "little Curies" by French troops). These units allowed surgeons to detect internal injuries and fractures, making surgery safer and more accurate by enabling surgeons to plan their procedures based on a clear understanding of the patient’s internal injuries.

Amputations and Prosthetic Limbs

The nature of the injuries sustained during World War One meant that many soldiers had their limbs amputated due to severe wounds. Advances in the design of prosthetic limbs helped many soldiers adapt to their new circumstances.

• Prosthetic Limbs: As a result of the war, more sophisticated and functional artificial limbs were developed. In London, a company that manufactured industrial tools began producing a metal prosthetic leg that was lighter and easier to manoeuvre than previous versions, helping soldiers regain more mobility.

James Edward Hanger and Prosthetic Limbs

One of the most influential figures in the development of prosthetics was James Edward Hanger, who became an amputee during the American Civil War. Frustrated by the ill-fitting and uncomfortable prosthetic limb he was given, Hanger used his background in engineering to design a new prosthetic that could bend at the knee and ankle, making it far more comfortable and functional. After observing the effects of trench warfare in Europe during World War One, Hanger’s company received contracts from both England and France to supply artificial limbs to injured soldiers. His designs, which focused on improving the comfort, mobility, and fit of prosthetic limbs, significantly improved the lives of countless soldiers who had suffered limb loss during the conflict.

Conclusion

World War One had a lasting impact on the field of medicine, particularly in the areas of surgery, plastic surgery, and prosthetics. The large number of soldiers who were injured provided medical professionals with opportunities to develop new techniques and treatments that would go on to save countless lives in the years to come. Harold Gillies’ work in facial reconstruction, Francis Derwent Wood’s sculpting of lifelike masks, and the improvements in blood transfusions, X-ray technology, and prosthetics were all direct responses to the injuries caused by the war. These advancements were not only important for the soldiers who benefitted from them but also set the foundation for future medical and surgical breakthroughs that would have a lasting impact on healthcare for decades.