1. www.educationforum.co.uk Twentieth Century Surgery

2. 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

3. Infection & Aseptic Surgery 19 th 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 1890’s) 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

4. 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

5. Plastic Surgery in the World Wars Plastic surgery is surgery designed to improve a person’s 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 2 nd World War to treat serious burns – such trials were aided by the use and mass production of penicillin to reduce infection

6. 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 world’s first face transplant. She has her face horribly maimed by dog

7. Heart Surgery Heart surgery was extremely dangerous and rarely tried before the 2 nd 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

8. 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 1960’s 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 1970’s 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

9. Possible Questions 1.Choose either 19 th century surgery or 20 th 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.