Plastic surgery pioneers

The pioneers of plastic surgery: Harold Gillies

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A New Zealand born surgeon who had trained in England, Sir Harold Delf Gillies CBE FRCS is often referred to as ‘the father of plastic surgery’.

This is because he developed a new method of facial surgery to treat the many soldiers who came back from the First World War with horrific facial injuries.

Prior to the First World War, swords, rifles and canon had been the standard weapons of war, but whilst these certainly caused some facial injuries, it was nothing like on the scale of WWI with its trench warfare, heavy artillery bombardment and shrapnel filled shells.

Posted to France in 1915, Harold Gillies witnessed these many horrendous facial injuries first hand. Some soldiers had huge jagged wounds where their flesh had literally been torn from parts of their faces, others had pulverized jaws or had no nose or eyelids.

 

Dedicated care for facial injuries

Returning to England with a specific desire to help these wounded soldiers, he first set up a dedicated ward for soldiers with facial wounds at the Cambridge Military Hospital in Aldershot.

However, he could see that more resources were needed to help the huge numbers of these soldiers coming back from the war.

As a result, in 1917 he established the first hospital dedicated to plastic surgery for facial injuries, The Queen’s Hospital at Frognal House in Sidcup, which had over 1,000 convalescent beds.

 

Pioneering graft procedures

During his work on injured soldiers, he discovered that facial wounds could be repaired through the use of a pedicle. This is a large flap of lifted skin whose free end can be swung over to the injured site, whilst remaining connected to the body and the blood supply.

He also mastered a technique for larger skin grafts using a tubed pedicle. Noticing that the edges of larger skin flaps curled in on themselves under tension, he sewed them into a tube and discovered that this not only maintained better blood supply but also reduced the risk of infection.

Once the tubed pedicle had become firmly attached near the injury, he could cut it free of the donor site, open the graft and spread it over a much wider area than with standard pedicles.

Harold Gillies’ work with pedicles for facial reconstruction was further developed by his cousin, Sir Archibald McIndoe in World War II.

 

After World War I

After the First World War, Harold Gillies set up in private practice, inviting his cousin Archibald McIndoe to join him. During the Second World War, Gillies was a consultant to the Ministry of Health, the RAF and the Admiralty and set up plastic surgery units in various parts of Britain. After WW2, he also became a pioneer in sex reassignment surgery, being one of the first plastic surgeons to carry out a sex reassignment from female to male in 1946 and then male to female in 1951.

 

Following in the footsteps of Harold Gillies

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