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Twentieth Century Surgery

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Blood loss

• In 1900 Karl Landsteiner discovered blood groups
  and that only compatible blood could be
  transfused successfully paving the way for a
  solution to blood loss
• The Red Cross set up the first blood transfusion
  service in 1926
• First blood bank set up in Barcelona in 1936
• World War II speeded up scientific research and
  in 1944 ACD or acid citrate dextrose was
  discovered as a solution to blood clotting in
  storage

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Infection Aseptic Surgery

• 19th century had used anti septic techniques to
  tackle infection e.g. Carbolic spray
• Aseptic techniques such as using rubber gloves
  (Halsted 1889) and boiling and sterilisation of
  equipment and clothing (Robert Koch 1890s)
  quickly became the norm in the early Twentieth
  Century
• Definitions anti septic means killing germs
  that exist in the operating theatre. Aseptic
  means creating a completely sterile or germ free
  theatre before you start

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Pain anaesthesia improved

• Better anaesthetics were discovered and devised
  in the 20th century. Increasingly local
  anaesthetics and muscle relaxants were used
  stopping the need to send the patient under
  completely for hours this made recovery quicker
  and risks smaller
• Examples
• In 1905 novocaine was used for the first time as
  a very effective local anaesthetic
• In 1942 curare first used as a muscle relaxant
  reducing the need for power general anaesthetics

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Plastic Surgery in the World Wars

• Plastic surgery is surgery designed to improve a
  persons appearance maybe because of burns or
  disfigurement and sometimes because of vanity
• Skin grafts were first pioneered in the First
  World War by Howard Gillies
• Skin grafts were further improved by Archie
  McIndoe during the 2nd World War to treat serious
  burns such trials were aided by the use and
  mass production of penicillin to reduce infection

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Plastic surgery Today

• Plastic surgery has advanced rapidly since the
  second world war thanks to high technology tools
  to join up nerves and repair skin
• Example in 2006 the French woman Isabelle
  Dinoire had the worlds first face transplant.
  She has her face horribly maimed by dog

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Heart Surgery

• Heart surgery was extremely dangerous and rarely
  tried before the 2nd World War
• War again paved the way for experimentation and
  risk taking. In 1944 the American surgeon Dwight
  Harken successfully managed to remove bullet
  fragments from living hearts. In the same year
  Canadian Bill Biggelow developed the technique of
  lowering the body temperature to give more time
  for surgeons to safely cut into the heart and its
  arteries
• This paved the way for further experimentation
  and by 1967 Christian Barnard carried out the
  first human heart transplant giving hope to
  patients with irreparable heart disease

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High Technology Surgery Some examples

• 1895 William Roentgen develops the X ray
  machine surgeons can see inside without cutting
  open
• Heart Lung machine invented 1953 allowed for
  surgeons to temporarily stop the heart during
  operations
• Powerful microscopes in 1960s allow for surgeons
  to join microscopic nerves and blood vessels
  allowing for reattaching severed arms and legs
• Artificial kidney machine invented by William
  Kolff 1943 has saved the lives of millions of
  kidney failure and patients
• Invention of fibre optic surgery and endoscopes
  1970s has allowed for key hole surgery
  operations deep in the body without general
  anaesthetic or deep cuts
• Laser surgery 1958 lasers cut through skin with
  much less bleeding lasers can also be used in
  cosmetic surgery to make skin appear younger

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Possible Questions

• 1.Choose either 19th century surgery or 20th
  century surgery which was more significant?
• Describe, explain and evaluate breakthroughs in
  both maybe use the 4Rs remember to come to a
  conclusion
• 2. Which factor has been more important in the
  development of surgery science/technology or
  War
• Describe, explain and evaluate detailed examples
  from both factors and come to a conclusion also
  hint at the significance of other factors than
  WAR and Science/Tech in your answer.