While the aforementioned advances in anesthesia and antisepsis had plastic surgeons performing complex procedures on delicate areas by the early 1900s, the burgeoning specialty had never seen challenges such as those presented by World War I. Entire new categories of explosives and weapons were being deployed on the battlefield, and thousands of soldiers were returning home with the types of injuries that had literally never been seen before.
It was in leading the response to these challenges that the field underwent perhaps its greatest sustained period of advancement, largely thanks to the efforts of New Zealand–born, London-based surgeon Harold Gillies, widely considered the father of modern plastic surgery. Recently uncovered records detail over 11,000 procedures performed on more than 3,000 soldiers in the eight years between 1917 and 1925, including groundbreaking skin and muscle grafting techniques that had never before been attempted. As antibiotics did not yet exist, infection was always a major concern. Dr. Gillies mitigated this by inventing the tube pedicle or “walking-stalk skin flap” technique, which involves rolling the graft to be used into a tube and “walking” it up to the target site.
This technique alone likely spared thousands from infections.When the war ended, Gillies and other wartime plastic surgery pioneers were frustrated to find that their techniques and expertise were not exactly welcomed with open arms by the medical community at large. The field was not well-defined, and its practitioners had no means of sharing expertise or defining areas of specialty until the American Society of Plastic Surgeons was founded in 1931.
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