The First World War was fought on a scale never experienced before --- hundreds of thousands of lives were lost in the four years of fighting and many more had to live with the trauma of facial injuries, but the new equipment and techniques that were invented, particularly in cosmetic and reconstructive surgery, would end up saving thosands of lives.
November 11, 2018 marks the 100th year of the end of the Great War or as we know it, World War I. On November 11, 1918, Allied leaders and German officials signed the Armistice that brought an end to four and a half years of fighting on the Western Front, effectively bringing World War I to a close. The war had begun after the assassination of Archduke Franz Ferdinand of Austria by South Slav nationalist Gavrilo Princip in Sarajevo on June 28, 1914, and continued for four years. An estimated 37 million people lost their lives.
Until First World War, humans were unaware of the dangers of war, the injuries they could sustain and the fatalities caused by arms. World War I made use of heavy artillery, machine guns, poison gases, bombs filled with shrapnel which caused maximum damage to the face.
It has been reported that by the end of World War I, around 735,487 British troops were discharged following major injuries, mostly caused by shell blasts and shrapnel. They sustained facial injuries and burns which made it difficult for the victims to see, eat, drink and socialise, as well as looking gruesome.
The victims, both civilians and soldiers, feared family reactions after they lost either their jaw, teeth or eyes in the war. The images of the soldiers, which are on display across museums and galleries, are still frightening to the eye. The soldiers suffered form post-traumatic stress disorder, often as a result of their deformities.
The large scale of facial injuries prompted doctors and surgeons to take out alternative methods to help victims return to normal.
The British army gave the responsibility of 'fixing faces' to young ENT surgeon Dr Harold Gillies from New Zealand who was a part of the British Army Medical Corps. Soon the first specialised hospital was opened in Sidcup, London, treating 2000 patients. It is reported to be the world’s first ever hospital dedicated to the treatment of facial injuries.
He tried fixing faces destroyed by shrapnel bombs and called it 'a strange new art'. The process involved making of prosthetics, false coloured eyeballs, fake noses, etc. Plaster casts of an injured patient’s face were taken, from which a facial reconstruction was made. A mask was then made, fitted to the patient and painted a skin colour.
As facial wounds became complicated, leading to new ways of treating them, the development of anaesthesia also became more important during the war. The Sidcup team developed a method of passing a rubber tube from the nose to the trachea, as well as working on the endotracheal tube (mouth to trachea) which was made from commercial rubber tubing.
Today, Gillies is referred to as the 'father of plastic surgery'. Many of the techniques he developed during the war are still used in modern facial reconstructive surgeries and prosthetics.
The horrific war gave the world innovations and lessons in patient safety, survival and pain management, all of which have benefited us to this current day.