Surgery Flashcards
(22 cards)
1
Q
Issues with Surgery in 1848
A
- pain - surgery very painful, had to be quick
- blood - many died from blood loss
- infection - no knowledge of sterilisation or germs
2
Q
Ether
A
- 1846 used by Liston in leg amputation
- 1847 used by Snow at St George’s London
3
Q
What was Liston’s nickname?
A
‘fastest knife in England’
4
Q
Chloroform
A
- 1847 used by James Simpson
- 1848 Snow chloroform inhaler
- 1853 Snow used on Queen V to deliver 8th child
5
Q
Drawbacks of Anaesthetics in the 1840s-50s
A
- chlroform - opposition from Christians (Bible said painless childbirth was unnatural)
- chloroform - hard to get dosage right; 1848 Hannah Greener toenail removal
- Black Period of Surgery
6
Q
Other Anaesthetics
A
- 1874 first IV General Anaesthetic used
- 1884 cocaine (addictive)
- 1898 heroine (addictive)
- 1903 first synthetic local anaesthetic
- 1905 novocaine (safer + less addictive)
7
Q
‘Black Period of Surgery’
A
- deaths from surgeries increased after new anaesthetics
- longer and more complex surgeries being attempted
- more deaths from blood loss and infection
8
Q
Semmelweis
Antiseptics
A
- 1847 Ignaz Semmelweis encouraged doctors to wash hands after handling corpses before delivering babies
- decreased deaths in mothers and babies
9
Q
Limitations of Semmelweis’ work
A
- resistance to ideas
- seen as a fanatic and even crazy
- committed to a mental asylum
10
Q
Carbolic Acid
Antiseptic
A
- 1860s used by Lister
- added on surgical wounds
- Lister noticed lower survival in air-exposed injuries
- Lister’s patients deaths fell from 45% to 15%
11
Q
Opposition to Carbolic Acid
A
- irritated skin
- expensive
- time consuming
- resistance by doctors and nurses
12
Q
Aseptic Surgery
A
- 1878 Koch steam steriliser
- 1887-94 all instruments sterilised before use
- ensured all germs were killed
13
Q
Catgut
Blood loss
A
- 1881 Lister experiments w/ catgut ligatures
- prevented blood loss and dissolved in the body after 3-4 weeks
- could be soaked in CA
14
Q
Blood Groups
Blood Loss
A
- 1901 Landsteiner discovers blood groups
- blood transfusions possible
15
Q
Developments with Blood in WWI
A
- 1914 first non-direct transfusion
- 1915 sodium citrate as anticoagulant
- 1916 glucose citrate increased storage time
- 1917 first blood bank on Western Front
16
Q
X-rays
A
- 1895 discovered by Röntgen after experiments w/ cathode rays
- used to see broken bones and show location of bullet / shrapnel
- Curie paid for mobile x-ray machines with own money
17
Q
Fighting Infection in WWI
A
- Carrel-Dakin method - irrigating wounds with sterilised salt solutions
- injuries often led to amputation (pre-antibiotics)
18
Q
Thomas Splint
A
- named after Hugh Owen Thomas
- held and secured broken femurs
- 1914 80% w/ femur fractures died
- 1916 80% survived
19
Q
Skin Grafts in WWI
A
- shrapnel lead to terrible facial disfigurement
- Harold Gilles set up specifically-designed hospital in Sidcup after Battle of the Somme where 2k patients treated
- facial reconstruction key part of rehabilitation
- 1916 Filatov pedicle skin grafts - growing skin to be grafted on other body parts
20
Q
Blood Transfusions during the Interwar Period and WWII
A
- USSR national blood banks 1930s
- 1938 Dr Chalres Drew separated plasma from blood; could be stored for much longer
- WWII Army Blood Supply Depot in Bristol
- WWII 4 civilian blood banks in London
- WWII allowed blood transfusion service to grow into efficient service
21
Q
Plastic Surgery in the Interwar Period
A
- 1920 Gilles published ‘Plastic Surgery of the Face’
- Russians developed ‘biogenic agents’ - encouraged healing and re-growth of damaged areas
- Filatov grafts and transplants for the eyes
22
Q
McIndoe’s work on Burns
WWII
A
- Gilles’ cousin
- became RAF surgeon in 1938
- operated on burned pilots w/ highly experimental methods
- ‘Guinea Pig Club’ - experimental methods
- used saline baths
- worked with East Grinstead community to treat psychological wounds
