GCSE · History · AQA · Spec 8145

Impact of war and technology on modern surgery

In World War I, a simple leg splint cut deaths from broken thigh bones from around 80% to 20%.

Weigh it up

Did war do more than technology to improve modern surgery?

The claim

War did more than technology to improve modern surgery.

Place each piece of evidence to load the balance. Mark the strong ones — they count double.

  1. World War I experiments stopped stored blood from clotting, so blood could be kept for weeks and the first blood banks were created.

    Evidence 1: does it support or challenge the claim?

  2. World War II plasma research led to larger blood banks, and since 1945 transfusion has been a normal part of surgery.

    Evidence 2: does it support or challenge the claim?

  3. The Thomas splint, in widespread use from 1916, cut deaths from fractured femurs from around 80% to 20%.

    Evidence 3: does it support or challenge the claim?

  4. Gillies and McIndoe rebuilt the faces of disfigured and burned soldiers, creating plastic surgery techniques still used today.

    Evidence 4: does it support or challenge the claim?

  5. X-rays show bullets and broken bones inside the body, so surgeons no longer need heavy cuts to find the problem.

    Evidence 5: does it support or challenge the claim?

  6. Keyhole surgery works through small cuts with tiny cameras, so patients suffer less trauma and heal more quickly.

    Evidence 6: does it support or challenge the claim?

  7. Robotic surgery brings less pain and shorter hospital stays, though a £2 million robot means it is not always available.

    Evidence 7: does it support or challenge the claim?

  8. Lighter, more durable prosthetic limbs, and now bionic arms controlled by brain signals, have changed care after surgery.

    Evidence 8: does it support or challenge the claim?

History · Cause & effect

How surgery beat the bleeding problem

Blood transfusion, from failed experiments to everyday surgery

Causes ←

What led here

Since World War I, blood could be stored for weeks in blood banks

Event

Plasma research

World War II

Blood transfusions became even more common during World War II.

→ Consequences

What followed

Blood could be transported more easily
Blood could be stored for even longer
Larger blood banks were created

World War I · The Thomas splint

How many lives could a splint save?

Before the Thomas splint, around 80% of soldiers with a fractured femur (thigh bone) died. Once the splint was in widespread use from 1916, what do you think the death rate fell to?

Your estimate

50%

0%100%

Rebuilding faces: the pioneers of plastic surgery

Both World Wars left huge numbers of soldiers with head and facial injuries that severely disfigured them. That demand drove plastic surgery forward fast. Tap a surgeon to see the move that mattered most.

Tap a figure to see what they did.

What technology changed in surgery

Four technologies, one question for each: what did it change for the patient?

Your turn

Write your judgement

'War did more than technology to improve modern surgery.' Write one paragraph giving your judgement on this claim, and explain why you reached it. [4 marks]

0 words · your answer stays on this page and is not sent anywhere.

WHAT YOU'VE LEARNED

A quick recap of today's lesson.

Blood banks, a simple splint and rebuilt faces, set against X-rays, keyhole cameras and a £2 million robot.

What you need to know

  • Blood loss was a major danger of surgery: lose too much and a patient could go into shock and die.
  • Blood groups were discovered in 1901, blood could be stored from World War I, plasma research in World War II made larger blood banks possible, and since 1945 transfusions have been common in surgery.
  • The Thomas splint (widespread from 1916) cut deaths from fractured femurs from around 80% to 20%; Gillies (1917) and McIndoe (World War II) developed plastic surgery for disfigured soldiers.
  • X-rays and keyhole surgery made surgery less invasive; robotic surgery means less pain and shorter hospital stays but costs so much it is not always available; prosthetic and bionic limbs improved care after surgery.
  • To judge war against technology, weigh them with a criterion: how many patients were saved, and how much each changed surgery.

The big picture

Two big forces have shaped modern surgery. War helped overcome the major problem of blood loss: blood groups were discovered in 1901, blood could be stored from World War I and moved more easily after World War II, and since 1945 transfusions have been routine. The wars also brought the Thomas splint, rebuilt faces through plastic surgery and put X-rays to work on a large scale. Technology has made surgery less invasive (X-rays, keyhole surgery), eased recovery (robotic surgery) and improved care after operations (prosthetic limbs). Judging which mattered more means weighing how many patients were saved against how much each changed surgery.

Key points

1War helped overcome blood loss: blood storage in World War I and plasma research in World War II led to blood banks and routine transfusions after 1945.
2The Thomas splint stopped the leg's joints moving, and deaths from fractured femurs fell from around 80% to 20%.
3The wars caused terrible facial injuries, so Gillies and McIndoe developed skin-grafting techniques still used in plastic surgery.
4X-rays were discovered in the 1890s but first used on a large scale in World War I, so they belong to both stories.
5Keyhole surgery means small cuts, less trauma and faster healing; robotic surgery means less pain and shorter stays, but a £2 million robot is not always available.
6A strong judgement names its criterion, lives saved or extent of change, and explains why one side outweighs the other.

Worked example

Problem

Explain why plastic surgery developed so rapidly during the two World Wars.

⚠ Watch out

Giving war the credit for discoveries made in peacetime. X-rays were discovered in the 1890s and blood groups in 1901, both before World War I. What war did was put X-rays to use on a large scale and push blood storage forward.

🧠

Memory hook

War tackled the three Bs: Blood (blood banks), Bones (the Thomas splint) and Burns and faces (plastic surgery). Technology goes See, Shrink, Speed, Replace: X-rays SEE inside, keyhole SHRINKS the cut, robots SPEED recovery, prosthetics REPLACE the limb.

✓

Check yourself

Blood groups were discovered in 1901, in peacetime. Does that weaken the claim that war helped overcome blood loss? Think about what still had to happen before blood was ready for an operation.

Flashcards

(15)
Why was blood loss such a danger in surgery?
Operations usually cause some blood loss, and if a patient loses too much they can go into shock and die.
What was discovered in 1901, and why did it make transfusions safer?
Blood groups. Surgeons realised a patient must get blood that matches their own type, or it will be rejected.
Why was blood so hard to store before World War I?
Blood starts to clot once it is outside the body, and clotted blood can no longer be transfused.
What did World War I experiments add to blood, and what did that make possible?
Glucose and sodium citrate. They stopped clotting, so blood could be stored for weeks, blood banks were created and more transfusions succeeded.
How did World War II move blood transfusion on?
Transfusions became even more common, and research on plasma let blood be transported more easily and stored for longer, so larger blood banks were created.
What changed for surgery once transfusions became common after 1945?
Blood loss was no longer a major problem, so surgeons could carry out complex operations they would once have avoided.
Why was a fractured femur so deadly in World War I?
The broken thigh bone often pierced the skin and nearby muscles, causing heavy blood loss.
How did the Thomas splint work, and what did it achieve?
It extended the leg so the joints could not move, reducing the damage the broken bone could do. From 1916, deaths from fractured femurs fell from around 80% to 20%. It is still used today.
Why did plastic surgery develop so fast during the World Wars?
Both wars left many soldiers with head and facial injuries that severely disfigured them.
Harold Gillies: what did he do?
In 1917 he set up a special hospital for facial injuries and developed new skin-grafting techniques to rebuild soldiers' faces.
Archibald McIndoe: what did he do?
In World War II he developed Gillies' techniques further, including the walking-stalk skin graft, to treat serious burns such as the loss of eyelids.
How did X-rays make surgery less invasive?
They show broken bones and objects such as bullets or shrapnel inside the body, so surgeons no longer had to make heavy cuts to find the problem.
How does keyhole surgery work, and why do patients heal faster?
Tiny cameras and narrow instruments work inside the body through small cuts, so the body suffers less trauma.
Robotic surgery: one benefit and one limit?
Patients report less pain and on average spend less time in hospital, but a da Vinci Xi robot costs two million pounds, so it is not always available.
How has technology improved care after surgery for amputees?
Prosthetic limbs are lighter, more durable and more useful, and some 21st-century patients have bionic arms controlled by electrical signals from the brain.

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