Surgery

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  • Created by: Julia
  • Created on: 07-06-13 14:37
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  • Surgery c1800 - present day
    • Pain
      • Anaesthetics
        • 1799 Laughing Gas
    • Infection
      • Antiseptic surgery
        • Using chemicals to kill germs and stop infection
        • Semmelweiss
          • Discovered link between dirt and disease
            • Made doctors wash hands
            • Drmatically reduced septicaemia
            • 1847, before Germ Theory
          • Not significant
            • Nobody took him seriously
            • Rude and bad communicator
            • Couldn't explain why washing hands worked
        • Lister
          • Read Germ Theory in 1865
          • 1865 first used carbolic acid to disinfect bandages
          • 1871 developed carbolic spray
          • 1877 moved to London
          • Opposition
            • Practical reasons
              • Carbolic acid was unpleasant
              • Irritated skin
              • Expensive
              • Slowed down operations
            • Lister kept changing methods
              • Didn't know what he was doing?
            • Surgeons were defensive
              • Lister implied they'd been killing their patients
              • Lister's arrogance and manner didn't help
          • Acceptance
            • Results
              • Lister's death rate fell from 46% to 15%
                • From one in two to one in six
            • Septicaemia bacterium
              • Discovered by Koch in 1878
              • Explained why Lister's methods worked
              • Germ Theory more widely accepted
            • Lister moves to London in 1877
      • Aseptic surgery
        • Sterilising the environment to stop germs getting into wounds
        • Koch discovered hot steam killed more germs than carbolic acid
          • All instruments sterilised
          • Rubber gloves used by 1894
        • More complex operations
          • Appendix 1880s
          • Heart 1896
    • Blood loss
      • Problems
        • Ligatures used since Pare in 1500s
          • Reduced blood loss
        • Surgeons unable to replace lost blood
          • Transfusions had been tried, usually didn't work
            • No knowledge of blood groups
      • Breakthroughs
        • 1901 Landsteiner discovers blood groups
        • 1907 First blood transfusion using blood types
          • Discovers that type O is universal donor
        • Storage of blood developed in WW1
          • Sodium Citrate stops blood clotting
          • Citrate glucose solution allows blood to be stroed for several days (Rous and Turner)
          • First Blood Depot used for Battle of Cambrai 1917
          • X Rays discovered 1895 by Roentgen
            • Used in hospitals within 6 months
            • Great for diagnosis to enable more successful surgery
            • Mobile X ray units developed by Marie Curie during WW1

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