Science of Conflict
Reconstructive surgery

 

Mutilation of soldiers takes on a horrible form on the battle field. It is particularly horrifying when these soldiers survive and have to live in the community once more with extreme disfigurement.

A social and more humane change came over the battlefield at about the same time as Florence Nightingale was tending to the wounded.

During WWII, a Russian sniper wrote in his diary how he took aim at a German soldier. At the moment he was about to squeeze the trigger the German turned his head to reveal that his face was completely blown off. At which point the sniper took pity on the soldier.

Plastic surgery is now recognised as an integral skill necessary for every battlefield hospital. But it was not always the case.

The skill of remodeling a damaged human face goes back to 800 B.C. where ancient Indian potters were producing pottery noses for adulterous wives disfigured by their husbands. It was in 1794 where two British Army doctors, stationed in India, witnessed an operation to create a false nose. Their report received a great deal of interest back in London.

Other accounts include an Italian medic by the name of Christopher Fiorovanti. Fiorovanti witnessed a sword man slice off an opponents nose in duel. Fiorovanti apparently picked up the nose, urinated on it to wash it and sewed it back on the man's face. To his surprise the nose reattached to the face.

The French surgeon Guillaume Dupuytren, pictured on the right, born in 1777, became famous for repairing facial wounds using skin grafts and clever stitching. But he was an exception and such attempts at reconstructive surgery were rare not only because of technical problems but also because the military saw no value in such procedures.
In fact, well into the twentieth century, disfigured German soldiers were simply patched up and sent back to fight. The French were no different with one French surgeon reported to have said "A plastic surgery patient looked horrible when he went into the operating theatre and ridiculous when they came out."
During the Battle of Britain, two brilliant plastic surgeons, a New Zealander Archibald McIndoe, pictured on the right and an Englishman Harold Gillies, performed near miracles on 4,000 serviceman suffering facial burns and horrible fractures. In some extreme cases they moulded plastic bones, which they inserted under mangled skin, pulled down skin from the scalp to cover reconstructed noses and in some cases attached fabricated chins to usable bone.
During the Korean War further advances were made with the manufacturing of smaller, lighter replacement bones and techniques to reconstruct joints. Modern day materials allow for very sophisticated surgery. Plastics that mimic the characterisitics of the human skin, ultra light and strong alloys to fashion new bone and computer programs that analyse the best ways to remodel a patients face have greatly improved the capability of the plastic surgeon.
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