WWI Surgery

• Antiseptic surgery


  Germs in the operating theatre are killed before they can infect wounds
• Aseptic surgery


  Equipment and clothing are sterilized with steam, there should not be any germs present in the operating theatre at all
• Aseptic operating theatre in 1910

  • Source B
• Operating theatre in a temporary Hut at a closety clearing station around 1916

  • Source C
• There are several compromises in the aseptic surgery during World War I compared to peacetime
• Compromises in aseptic surgery during World War I


  • Large windows for light which could be a vector for germs
  • Surgeons wearing hair coverings but not face coverings
  • Medical orderlies wearing usual uniforms without precautions
• Aseptic surgery in World War I is not true aseptic surgery as certain compromises had to be made due to wartime conditions
• Plastic surgery


  Reconstructing faces using skin grafts, as developed by Harold Gillies
• Patients with facial wounds


  • Badly wounded pilot
  • Soldier with deep shrapnel wound to nose
• Facial reconstruction using skin grafts


  1. Gradual rebuilding of face using skin grafts

  2. Use of tubed pedicles to move skin grafts while maintaining blood supply
• Plastic surgery techniques developed during World War I were pioneering and experimental, but would have further benefits in peacetime
• Brain surgery techniques were also developed during World War I, led by Harvey Cushing
• Soldiers wearing steel helmets after 1916


  Head injuries actually went up, as more people survived head wounds that previously would have been fatal
• Advances in brain surgery during World War I


  • Importance of quick operation and allowing time for brain swelling to go down
  • Use of local anaesthetic to avoid harmful brain swelling from general anaesthetic
  • Careful examination of all head wounds to identify full extent of injury
  • Action taken to prevent and treat infections
• Cushing's brain surgery techniques had a 21% higher survival rate compared to other surgeons
• Truly aseptic surgery was virtually impossible in some World War I circumstances, so antiseptics were used alongside aseptic techniques
• Advances in surgery during World War I built upon 19th century progress and had significant impact on peacetime surgery