The metrics from the First World War are horrible. In total there were 37 million soldiers and civilian casualties – 16 million dead and 21 million wounded.
Never before had a conflict so devastated in terms of death and injury.
In response, during the four years of the war, military surgeons developed new techniques on the battlefield and in support hospitals that resulted in more survivors of injuries during the first two years of the war that would have occurred during the first two deaths.
On the western front, 1.6 million British soldiers were successfully treated and returned to the trenches.
By the end of the war, 735,487 British troops had been fired after serious injuries. Most of the injuries were caused by garnet blasts and shrapnel.
Many of the injured (16%) had facial injuries, more than a third of which were serious & # 39; was considered.
Historically, this was an area where very little had been tried, and survivors with severe facial injuries showed large deformities that made it difficult to see, breathe easily, or eat and drink – and look horrifying as well.
A young surgeon ENT (ear, nose and throat) from New Zealand, Harold Gillies, who worked on the Western Front, tried to repair the injuries of facial injuries and realized that there was a need for specialized work.
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The horrifying scale of facial injuries in the First World War drove doctors and sculptors to develop methods to help patients move on without feeling mutilated. A surgeon from New Zealand developed a technique for skin grafting, where a & # 39; mask & # 39; of the skin over the face and the eyes of the person was produced. They also fitted those who needed them with glass eyes, and made a pair of fake glasses to keep everything as innocent as possible. Shown: an archive image of one patient before (left) and after (right)
The story of prosthetics was touched in the hit show Boardwalk Empire with a character played by Jack Hutson who had the tell-tale and face mask
Timing was good because military medical leadership recognized the benefit of setting up specialized centers for dealing with specific injuries and wounds, such as neurosurgical and orthopedic injuries or gas-induced victims.
Gillies was given permission to set up the first department for plastic surgery in Great Britain in January 1916 at the Cambridge Military Hospital in Aldershot.
No one has won the last war, but the medical services. The increase in knowledge was the only determinable gain for humanity in a devastating catastrophe
Gillies toured basic hospitals in France to find suitable patients who could be sent to his unit.
He returned in the expectation of about 200 patients – but the opening of the unit coincided with the opening of the Somme offensive in 1916, and more than 2,000 patients with facial injuries were sent to Aldershot.
Treatment was also required for sailors and pilots who suffered from burns in the face.
Gillies described the development of plastic surgery as a "strange new art."
Many techniques were developed by trial and error, although a part of mirrored work that was done centuries ago in India.
This is a close-up of a prosthesis for an eye and eyelid, attached to glasses to keep them fixed
A selection of newly formed noses, eyes and eyelids in France in 1918 for wounded soldiers
The designers of prosthetics made a mold from the face of the person with the help of papier mache to get the correct shape of their face. Once it was made, they would paint on their facial features and skin
Making colored glass eyeballs: craftsmen use cut glass and enamel to make glass eyes for soldiers who lost their eyes in the First World War. A bulb glass is blown and the color is applied (top left); the eyes are baked and the colors are set (top right); the eyeball is cut to size (bottom left); the finished article is carefully polished (bottom right)
One of the most important techniques that Gillies developed was transplanting the skin of the tube.
A piece of skin was separated but not detached from a healthy part of the soldier's body, stitched into a tube and then attached to the injured area.
A time was needed to allow a new blood supply at the implant site.
It was then released, the tube opened and the flat skin sewn over the area to be covered.
One of the first patients to be treated was Walter Yeo, gunnery warrant officer at HMS Warspite.
Yeo sustained injuries to the face during the Battle of Jutland in 1916, including the loss of his upper and lower eyelids.
The tubule of the tube produced a & # 39; mask & # 39; of the skin that had been grafted over his face and eyes, and produced new eyelids.
The results, although far from perfect, meant that he had a face again. Gillies repeated the same kind of procedure with thousands of others.
Four photo's that document the face reconstruction of a soldier whose cheek was wounded extensively during the Battle of the Somme in July 1916
Craftsmen painted the mask while it was on the soldier, so that it closely matches the actual skin color of the soldier. Pictured above is a seriously deformed soldier and on the right he is depicted with the mask made
There was a need for larger facilities for surgical and post-operative treatment and also rehabilitation of patients, together with the different specialisms involved in their care.
Gillies played a major role in the design of a specialized unit at Queen Mary's Hospital in Sidcup, in south-east London.
It opened with 320 beds – and at the end of the war there were more than 600 beds and 11,752 operations were carried out.
But reconstructive surgery continued long after hostilities ceased and by the time the unit was finally closed in 1929, about 8,000 soldiers were treated between 1920 and 1925.
The details of the injuries, the operations to correct them and the final outcome were all recorded in detail, both by early clinical photography and by detailed drawings and paintings made by Henry Tonks, who although he had been trained as a physician, had given up on medicine for painting.
Tonks became a war artist on the western front, but then joined Gillies to help not only in the new plastic procedures, but also in their planning.
The complex facial and head surgery required new ways to give anesthesia.
Two wounded soldiers played cards after full face prostheses in April 1919
Anesthesia was generally advanced as a specialty during the war years – both in the way it was administered and in how doctors were trained (previously anesthesia was often given by a young member of the surgical team).
The survival of operations requiring anesthesia improved, although the techniques were still based on chloroform and ether.
The Queen Mary anesthetic team developed a method to lead a rubber tube from the nose to the trachea (trachea), and also worked on the endotracheal tube (mouth to trachea) made of commercial rubber tubing.
Many of their techniques remain in use today. As an Austrian doctor wrote in 1935: "No one has won the last war, but medical services. The increase in knowledge was the only profit to be determined for humanity in a devastating catastrophe. & # 39;
- This article was originally published by The Conversation
- The author would like to acknowledge the help of Norman G Kirby, major general (retired), director of the army surgery 1978-82
The American socialist and sculptor who followed her doctor-husband to Europe at the beginning of the First World War changed the lives of nearly 200 soldiers who had been deformed in the fight by portrait masks & # 39; to make that they could wear to hide their facial injuries
by Regina F Graham, functions reporter for DailyMail.com
- Anna Coleman Ladd helped nearly 200 soldiers with facial deformities from the First World War through portrait masks & # 39; to make
- She was born in 1878 to a prominent family just outside Philadelphia and studied sculpture in Europe before marrying her husband in 1905 and moving to Boston.
- The couple moved to France in 1917, where she founded the American Red Cross Studio of Portrait Masks and employed four assistants to help her
- The noble services of Ladd provided her with the Légion d & # 39; Honneur Croix de Chevalier and the Serbian Order of Saint Sava
More than 16 million soldiers and civilians died in the First World War, making it the deadliest war in history. Many of those who survived the battlefield did so with serious injuries to the face, and it proved difficult to go home with a drastic change in appearance.
They were worried about how both family and friends would react and how they would be treated because they missed a nose, eye or pieces of their jaw line after maintaining disfigurements caused by shrapnel, bullets and flamethrowers.
In an attempt to restore some normality to their lives, the American sculptor Anna Coleman Ladd, who had moved to Paris with her husband at the beginning of the war, created portrait masks based on the image of men's photos. before their injury.
"A man who came to us was injured two and a half years earlier and never been home", according to a 1919 report from the Ladd workshop that was published by the Smithsonian Museum as part of its archives .
He did not want his mother to see how bad he looked. & # 39; From his whole face there was only one eye left and after 50 operations. . . he came to us.
People get used to missing men with arms and legs, but they never get used to an abnormal face. & # 39;
Anna Coleman Ladd, an American socialite and sculptor who followed her doctor-husband to Europe at the beginning of the First World War, found her craft in prostheses. She transformed the lives of more than 200 soldiers. Here she is working on a prosthetic mask worn by a French soldier to hide his deformity in July 1918