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Facial Reconstruction in the First World War

The outbreak of war in 1914 saw both staff and Council members of The Royal College of Surgeons of England (RCS) join the war effort, in the capacity of providing military and medical service at home and abroad. As well as investing £100,000 in the War Loan, it lent the expertise of its staff and associates to the cause. Council members played key roles in the coordination of military surgery and the College itself was called on to advise the Government on how to deal with the medical demands of the conflict.1

Patient Records

The RCS archives include collections relating to the First World War which cover the medical and social history of the War. One of its most significant collections is the Gillies Patient Record files of British and New Zealand servicemen.2 Gillies Patient Record files detail the injuries of the patients, which ranged from gunshot wounds and shell or shrapnel wounds to burns, mainly of the face. The files are arranged alphabetically by patient's surname and each patient has been assigned a unique ID or case number; they list rank, regimental number, regiment, age, and date of wounding so that the battle in which they were wounded can often be identified. There are clinical operation and progress notes, and some of these records are accompanied by photographs or diagrams relating to their injuries and operations. Some of the diagrams were hand-drawn by Henry Tonks (Fellow RCS 1888), an artist and surgeon, and annotated by the surgeons. In some cases, there are prints of x-rays.

There are also watercolour portraits to accompany some of the files for patients from New Zealand, which show their injuries on admission to the centre. Many of the watercolours are unsigned, but identified artists include Daryl Lindsay and Herbert R. Cole, a book illustrator and portraitist. 

Sir Harold Gillies (1882-1960)

Having worked in otolaryngology, it was not until the First World War that Sir Harold Gillies (Fellow RCS 1901) began to develop maxillo-facial surgery and has since been considered by some to be the father of plastic surgery.

Gillies developed and devised independently the potential and varied applications of a new medical technique, the tubed pedicle and the twin tubed pedicle. This used grafted flaps of skin and also tissue from other parts of the body. He was distinguished for his thorough pre-operative planning clinics, which contributed to his precisely planned procedures.

Following the outbreak of the War, Gillies joined the Royal Army Medical Corps (RAMC). He witnessed first-hand the horrific effects of war and the disfigurement of men caused by battle. He also worked alongside renowned dentist Charles Auguste Valadier. Gillies was inspired by Valadier’s efforts to repair jaw wounds using new skin graft techniques. He also went on to observe renowned surgeon Hippolyte Morestin, a pioneer in maxillo-facial surgery, to learn more about skin grafting. Their advances underpinned much of the work that he later did and led him to recognise the need and importance of starting special treatment in this field. He managed to persuade the War Office to allow him to set up a dedicated unit at Aldershot, Hampshire. Following the Battle of the Somme, Aldershot proved to be inadequately equipped to cope with the demand of the massive influx of casualties. Gillies pressed for a larger, purpose-built facility, devoted exclusively to plastic surgery, to replace the unit. With the help of Sir William Arbuthnot Lane, Chief Army Surgeon of the RAMC, a hospital was built at Sidcup, Kent. The Queen's Hospital opened in June 1917. It became the largest centre of its kind in the world and was developed as the War's major centre for pioneering maxillo-facial and plastic surgery. Between 1917-1921, the hospital and its associated convalescent units admitted over 5000 servicemen and completed more than 11,000 operations.

Gillies often called on the talents of artists to help him. The sculptor F. Derwent Wood collaborated with Gillies in cases when the manipulation of living tissues needed to be supplemented with modelling in an artificial substance, such as wax. In 1915 the ex-surgeon turned artist Henry Tonks, volunteered to paint portraits of men with facial injuries and helped to design their repair.

The Team

The War led surgeons to attempt ground-breaking procedures, through trial, practice and experiment. In Gillies’ case, he had the foresight to use a multidisciplinary approach, working closely with a range of medical staff such as dental surgeons and other surgeons, who formed his team of experts (also consisting of physicians, anaesthetists, nurses, and artists) and this enabled him to carry out such pioneering work. The meticulous detail of the injuries recorded in the drawings and paintings helped record his procedures. These also act as a record of the extent of the horrific injuries sustained by the soldiers during the war. Gillies’ notes highlight the importance of record-keeping, and the way in which it served to influence future generations.

Gillies and his team made a significant contribution to the First World War through his innovative treatment and the advancement of reconstructive surgery.

After the War


Gillies saw that his new specialty was still necessary in peacetime. He set up in private practice, was elected to the staff at St Bartholomew’s and was appointed consultant in plastic surgery to the Royal Navy, The Royal Air Force, the Queen Alexandra Military Hospital and, St Andrew’s Hospital, Dollis Hill, St James’s Hospital (Balham), the North Staffordshire Royal Infirmary, the London County Council Hospital, and the Ministries of Health and of Pensions.

Following the outbreak of the Second World War in 1939, he organised plastic surgical units in different parts of the country and personally supervised the largest unit at Park Prewett Hospital, Basingstoke. Shortly after the war Gillies formed the British Association of Plastic Surgeons of which he was the first president. He was also honorary president of the International Society of Plastic Surgeons. He continued to train and teach people from all over the world, as well as, operating and advising. In 1920 his book ‘Plastic Surgery of the Face’ was published, setting down the principles of modern plastic surgery and becoming the leading textbook in its field.

After his death, the British Association of Plastic Surgeons created a fund in his memory to promote education and research in plastic surgery.

RCS Archive

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Corporal W McRae (artist unknown)
Watercolour portrait of Corporal W McRae, the follwoing images are from his case file.
Gillies British Patient File of Corporal W McRae

Gillies British Patient File of Corporal W McRae

by Karyn French | 03 Nov, 2016

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    Cara Menghilangkan Benjolan Wasir Wasir adalah pembuluh darah teriritasi dan meradang terletak di anus, sedangkan kanker disebabkan oleh sel-sel yang berkembang biak di luar kendali. Wasir tidak dapat menyebabkan kanker dubur. Dalam beberapa kasus yang jarang, orang dengan kanker dubur yang paling bertanggung jawab untuk memiliki wasir. Hal ini terjadi karena meningkatnya tekanan pada tumor. Cara Cepat Mengobati Benjolan Wasir Atau Ambeien

    Cara Alami Menghilangkan Benjolan Wasir Sebelum tahu bagaimana cara mengobati penyakit ini, ada baiknya jika kita terlebih dahulu tahu bahwa pada dasarnya penyakit ini berhubungan dengan gangguan pada pembuluh darah, dengan ciri berupa pembengkakkan dan dapat menimbulkan rasa tidak nyaman setelah penderita buang air besar. Jika penyakit ini masih tergolong ringan, mungkin saja bukan merupakan masalah besar bagi sebagian penderita. Selain itu gejala lain yang dapat terlihat adalah pembuluh darah pada bagian bokong mengalami pembengkakan. Dengan mengetahui penjelasan dasar tentang penyakit ini maka diharapkan kita dapat melakukan pengobatan yang sempurna.  Cara Menghilangkan Benjolan Wasir

    Obat Untuk Mengatasi Gatal Eksim Ada dua jenis eksim yang di kita kenal , yaittu eksim basah & eksim kering .Masing2 memiliki tanda yang berbeda , namun keduanya bertalian karena eksim basah merupakan perkembangan dari eksim kering . Dan dari kedua eksim ini , hanya eksim basah yang bisa menular dari seseorang ke orang lain. Karena eksim basah merupakan phase awal dari eksim , sehingga bakteri/kuman masih sangat aktif. Obat Untuk Mengatasi Penyakit Gatal Eksim

    Obat Ambeien Seperti yang sudah disebutkan dalam penjPada dasarnya penyakit ini berhubungan dengan konstipasi atau karena penderita mengedan terlalu berlebihan pada saat melakukan buang air. Selain itu wanita yang sedang hamil juga beresiko terkena penyakit ini karena adanya peningkatan tekanan dalam rahim selain peningkatan tekanan dalam pembuluh darah juga bisa menyebabkan hal ini terjadi.  https://medium.com/@shddenature/obat-ambeien-herbal-ampuh-9b0badb762d14

    Kenapa Kemaluan Mengeluarkan Nanah Bagi Anda yang merasakan penyakit tersebut jangan takut dan khawatir karena sekarang ini terdapat obat gonore untuk pria. Obat ini memang dikhususkan bagi pria yang mengalami masalah pada alat kelaminnya. Selain itu, obat gonore satu ini berbeda dengan obat pada umumnya karena obat ini benar-benar berkhasiat dan tidak menimbulkan efek samping bagi si penderitanya seperti obat-obatan dengan menggunakan obat-obatan kimia dan penggunaan teknologi. Kemaluan Keluar Nanah

    Cara Mengobati Ambeien Yang Keluar Darah Seperti yang sudah disebutkan dalam penjPada dasarnya penyakit ini berhubungan dengan konstipasi atau karena penderita mengedan terlalu berlebihan pada saat melakukan buang air. Selain itu wanita yang sedang hamil juga beresiko terkena penyakit ini karena adanya peningkatan tekanan dalam rahim selain peningkatan tekanan dalam pembuluh darah juga bisa menyebabkan hal ini terjadi.  Bagaimana Mengobati Ambeien Yang Keluar Darah

    Cara Mengatasi Gatal Eksim Di tangan Sediakan daun ketepeng yang dipercaya pula mampu menjadikan eksim jauh lebih baik dan menghilang dengan cepat. Bersama dengan daun tersebut, siapkan pula kunyit sepotong dan daun asam muda secukupnya.  Bagimana Cara Mengobati Gatal Eksim

    Klik disini Dalam pengertian menurut bahasa, wasir atau hemoroid berasal dari kata haima dan rheein yang di ambil dari bahasa Yunani yang berarti darah yang mengalir. Wasir bisa juga di artikan sebagai suatu gejala dimana pada bibir anus ataupun pada dinding rektum atau usus besar terjadi pembengkakan jaringan yang diakibatkan oleh adanya pelebaran pembuluh darah balik atau vena yang biasanya di sertai dengan pendarahan dan timbulnya rasa nyeri.  Cara Menghilangkan Benjolan Ambeien

    Bahaya Terkena Asam Urat, Asam urat merupakan penyakit yang kerap menyerang orang tua. Namun, jangan salah, kini mulai mengincar usia muda. Tak sedikit mereka yang sudah berusia di akhir 30-an mengeluhkan asam urat., Cari Tanaman Obat Asam Urat

    Obat Ambeien Herbal Aman Untuk Bumil Wasir terbentuk karena perluasan pembuluh darah di daerah anus. Lama kelamaan pembuluh darah di daerah anus itu akan mengalami peningkatan dalam ukuran. Selain itu, tekanan besar pada rektum juga menyebabkan pembuluh darah yang mengandung darah semakin meluas dan akhirnya menyebabkan pembentukan wasir atau tumpukan. Jika Anda adalah salah satu dari jutaan orang di seluruh dunia yang menderita penyakit ini dan ingin menyingkirkan wasir, maka Anda perlu untuk memperhatikan secara khusus mengenai segala hal yang berhubungan dengan upaya pengobatan wasir dengan obat yang tepat dan dilengkapi dengan obat herbal alami, selain itu tidak boleh dilupakan mengenai upaya adaptasi dengan perubahan gaya hidup baru yang bertujuan supaya penyakit ini tidak berulang kembali. Klik disini

    kunjungi website Salah satu penyakit berbahaya bagi setiap orang adalah kanker payudara. Penyakit ini dapat menyerang siapa saja baik wanita maupun pria. Meskipun demikian wanita memeang memiliki kecenderungan lebih besar untuk terkena penyakit kanker payudara. Ada beberapa gejala yang muncul pada penderita penyakit kanker payudara. Yang pertama adalah munculnya benjolan di area bawah kulit payudara. Biasanya benjolan ini sebesar kacang polong. Gejala lain yang muncul adalah keluarnya cairan atau darah dari benjolan tersebut. Terkadang selain darah cairan lain seperti nanah juga dapat keluar dari benjolan tersebut. Biasanya keluarnya cairan juga disertai dengan munculnya rasa nyeri yang mengganggu penderita. Gejala lain yang terlihat adalah area di sekitar benjolan akan berubah menjadi berwarna kemerahan. Selain berwarna kemerahan biasanya area tersebut juga akan terlihat kasar seperti bersisik. Mengobati Penyakit Kanker Payudara Stadium Awal

    http://obatherbalnomersatu.blogspot.com/2016/06/dari-kemaluan-mengeluarkan-nanah-kental.html Hal ini disebabkan karena bakteri tersebut merupakan salah satu bakteri jahat dan cukup berbahaya menyerang alat kelamin. Penyebab utama terjadinya penyakit ini disebabkan oleh faktor hubungan seksual yang kurang sehat dan berlebihan Selain itu, penyebab lain dari sakit ini adalah faktor kebersihan yang kurang dari pribadi sendiri sehingga penyakit ini berkembang dengan cepat khususnya pada wanita yang kurang menjaga alat kelamin sensitifnya sehingga tidak jarang akan menimbulkan penyakit tersebut.  http://obatherbalnomersatu.blogspot.com/2016/06/dari-kemaluan-mengeluarkan-nanah-kental.html

    Info selengkapnya Wasir terbentuk karena perluasan pembuluh darah di daerah anus. Lama kelamaan pembuluh darah di daerah anus itu akan mengalami peningkatan dalam ukuran. Selain itu, tekanan besar pada rektum juga menyebabkan pembuluh darah yang mengandung darah semakin meluas dan akhirnya menyebabkan pembentukan wasir atau tumpukan. Jika Anda adalah salah satu dari jutaan orang di seluruh dunia yang menderita penyakit ini dan ingin menyingkirkan wasir, maka Anda perlu untuk memperhatikan secara khusus mengenai segala hal yang berhubungan dengan upaya pengobatan wasir dengan obat yang tepat dan dilengkapi dengan obat herbal alami, selain itu tidak boleh dilupakan mengenai upaya adaptasi dengan perubahan gaya hidup baru yang bertujuan supaya penyakit ini tidak berulang kembali. Ambeien Keluar Darah Saat BAB

    Bagaimana Cara Mengobati Eksim Dengan Lidah Buaya? Penyebab eksim sebenarnya adalah respon dari suatu alergi yang di miliki oleh penderitanya. Jadi jika memiliki alergi makanan, lalu setelah mengkonsumsi makanan tersebut bisa menimbulkan gatal dibagian kulit tertentu sehingga mulai terbentuk eksim dengan cepat. alergi yang sering memicu alergi ialah alergi pada makanan, dan juga pada debu sehingga penderita asma bisa juga mengalami eksim kulit.  Obat Herbal Gatal Eksim

    Daftar Obat Ambeien Yang Sudah Terdaftar Di BPOM Sedangkan jenis ambeyen yang berikutnya adalah ambeyen eksternal yang biasanya terjadi pada bagian bawah kulit yang mengelilingi anus, ambeyen ini dapat dirasakan ketika membengkak hingga kemudian dapat menyebabkan rasa gatal-gatal dan nyeri pada gerakan usus serta kemudian menimbulkan pendarahan. Bisanya jenis ambeyen ini terjadi ketika adanya bekuan darah dalam vena hingga rasa nyeri yang terjadi semakin signifikan.  Obat Ambeien Alternatif Terdaftar Di BPOM

    http://mp3illusion.com/2018/07/sebab-kemaluan-mengeluarkan-nanah/ Gejala penyakit gonore atau kencing nanah, Gejala pertama GO umumnya timbul setelah 2 – 10 hari setelah terpapar oleh bakteri GO. Tetapi pada beberapa kasus, infeksi telah terjadi berbulan-bulan baru timbul gejala. Menyembuhkan Kemaluan Mengeluarkan Nanah

    Cari Obat Herbal Kanker Serviks Ciri kanker serviks pertama adalah rasa sakit saat melakukan hubungan badan. Tidak jarang organ intim perempuan sampai mengeluarkan darah. Terkadang, darah tersebut juga keluar bersama urin. Jika Anda mengalami kejadian tersebut, Anda patut waspada. Sebab kanker serviks memang sering menyebar lewat hubungan seksual. Virus Human Papiloma yang menjadi penyebab kanker serviks sering menyebar melalui hubungan intim. Herbal Kanker Serviks Paling Mujarab

    Cara Efektif Mengobati Kemaluan Keluar Nanah Hubungan seks anal juga dapat menularkan bakteri ini karena sedemikian gampangnya bakteri menular. Oh iya, penggunaan kondom dapat mencegah penularan penyakit ini. Pastikan kondom yang anda pakai masih baru dan tidak rusak atau kadaluarsa. Hindari juga oral seks jika itu tidak penting sekali karena bakteri ini juga bisa menular lewat mulut-mulut, mulut-penis/vaginal, mulut-anal. Cara Ampuh Mengobati Keluar Nanah dari Kemaluan Pria

    Cara Manjur Hilangkan Ambeien Cara mengobati ambeien dapat anda tempuh dengan dua metode atau cara perawatan di rumah dan perawatan medis, untuk perawatan di rumah biasanya menjadi pilihan terfavorit oleh para penderita penyakit ambeien, karena selain mudah melaksanakan dan tentunya biaya yang dibutuhkan akan lebih murah apa bila di bandingkan dengan perawatan medis. https://medium.com/@shddenature/obat-ambeien-herbal-ampuh-9b0badb762d6

    Menyembuhkan Penyakit Wasir Dengan Herbal Cara mengobati ambeien dapat anda tempuh dengan dua metode atau cara perawatan di rumah dan perawatan medis, untuk perawatan di rumah biasanya menjadi pilihan terfavorit oleh para penderita penyakit ambeien, karena selain mudah melaksanakan dan tentunya biaya yang dibutuhkan akan lebih murah apa bila di bandingkan dengan perawatan medis. Mengobati Wasir Yang Kambuh Berulang ulang
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    Credits/footnotes:
    Archive reference: RCS-COM/5/1
    Archive reference: MS0513.This collection consists of 52 boxes and contains patient records for over 2,000 servicemen who underwent plastic surgery at the unit set up by Sir Harold Gillies at Queen's Hospital, Sidcup. The files serve as a record of how treatment was facilitated, and also help to document the development of plastic surgery at the beginning of the Twentieth Century.

    Images:
    (except watercolour) Gillies British Patient File of Corporal W McRae, Archive reference: MS0513/1/1/ID 1363, The Archives of the Royal College of Surgeons of England.

    Watercolour portrait of Corporal W McRae (artist unknown), Archive reference: MS0513/2/2/ ID 164, The Archives of the Royal College of Surgeons of England.