Plastic Surgery

Medical and dental officers trained in plastic surgery arrived in the Middle East early in 1942, following a period of special training in England, and were distributed between the hospitals, with Helwan as the headquarters, where all the cases were to be concentrated following preliminary treatment at the other hospitals. By May a saline bath unit was installed at Helwan, the tannic acid treatment of burns having been abandoned, and dressings of sulphanilamide powder and tulle gras or vaseline gauze substituted. The saline bath was used both for burns and also for cleaning up large infected gunshot wounds prior to skin grafting. Sulphonamide drugs by mouth were also used in the treatment of infections such as those due to the streptococcus, with favourable results. As far as maxillo- page 309 facial work was concerned, not many cases of fracture of the jaw were admitted.

Plastic surgery training had followed a generous offer in February 1940 by Sir Harold Gillies, in London, to accept New Zealand medical officers for special training in this branch of surgery. In December 1940 Captain Brownlee,¹ NZMC, and Captain Gilbert,² NZDC, were sent direct from New Zealand to England for a full course of training to enable them to establish a plastic surgery unit in New Zealand when sufficient wounded requiring specialised attention for disfigurement, etc., had been invalided home.

At the same time it was arranged by DMS 2 NZEF that Lieutenants Manchester, Hutter, and Dunne,³ and dental officers, who were with the Second Echelon in England, should undergo short courses of training.

After delivering a series of lectures on maxillo-facial surgery to NZMC officers in the Middle East in April 1942, Major Brownlee returned to New Zealand to organise a plastic surgery unit there for the long-term cases from the forces.

A review of cases evacuated to New Zealand up to February 1942 showed that there had been only eleven cases possibly requiring treatment in New Zealand, including two possible bone grafts for the mandible and two cases of burns with deformity. It was suggested by the Consultant Surgeon that the plastic surgery team in New Zealand should combine civilian work at one of the larger hospitals with the small amount of military work then offering.