SCIENCE & INNOVATIONS How do you light an operating theatre? The photograph below is interesting - it was taken around 1902 and shows the operating theatre in Salisbury General Infirmary. You can see newly installed electric light ceiling pendants alongside the old wall mounted gas lamps. Theatres were placed at the top of the building in order to use sky-lights in the ceiling to illuminate the work of the surgeon. A mill on Fisherton Street, Salisbury was converted to a power station by the Salisbury Electric Light and Supply Co in 1899 and the hospital was probably one of the first to benefit from the new power. Keyhole surgery theatres we use today (above) are very different and use digital imaging to help guide the surgeon during operations. Page 1
TECHNOLOGY FROM WAR A little known fact: The first kidney dialysis machine was developed here at Salisbury by Dr Edward Darmady (1906-1989). He was the Salisbury Infirmary Assistant Pathologist in the 1930s and RAF Squadron leader during World War 2. In 1946 Darmady experimented in constructing his own dialysing machine that was powered by parts dismantled from World War 2 spitfires. Clinical results were never published, but it is known that at least two patients survived the treatment, and Darmady is recorded as creator of the first dialysing machine in England. We have archive film footage of those experiments. World War 2 to modern day After the war the US army handed back the Odstock site, which had been used as a military hospital to receive casulties from the D-Day landings, to use as a local community hospital. During World War 2, on the homefront, there were many thousands of casualties caused by bombing raids. During this time, the government provided free medical care for everybody. In 1945, the Labour Government were elected and they had promised that if they won the election they would look after the welfare of all classes. They promised that they would ensure that the people had good housing, education, social care and health. The minister for health was a Welshman called Aneurin Bevan and he was responsible for introducing the National Health Service as we know it today. Because of the drastic need for medical care during war time great advances in technology, medicine and surgery were developed - for example: Here at Salisbury we continue to specialise in Plastic Surgery and Burns treatments, which were improved dramatically as a direct result of progress during World War 2 (see next page for more) During the war blood transfusions became safer and civilians were able to donate blood Pencillin was also developed Page 2
PLASTIC SURGERY AND BURNS AT SALISBURY John Barron (1911-1992) founder of the Wessex Regional Plastic Surgery Unit With the start of the NHS in 1948, a specialist Wessex Plastic Surgery Unit, which had been in Rooksdown House, Park Prewett Hospital at Basingstoke during the war, now needed a new home. Salisbury Hospitals Group Management Committee had recently taken the keys of the hutted wartime hospital on the hillside by the road to Odstock village. Several wards were being used for the care of tuberculosis patients, but the rest of the site was not being used. So it was decided that the Regional Plastic and Oral Surgery Centre should use buildings on the south side of the Odstock site, and working clinics began in 1949. After World War 2 Dr Barron was invited by the Foreign Office to lead a team setting up a hospital for reconstructive surgery in Yugoslavia. He stayed involved with this foundation for the rest of his life and in 1975 he received that nation s highest decoration, the Yugoslav Flag with Golden Wreath, for his contribution. Here at Salisbury Dr Barron s unit attracted students from across the world to learn the specialties of reconstructive surgery. It was soon realised that the treatment of burns cases was equally vital to the reconstructive process and a specialist Burns Unit came into being at Odstock in 1952. This was further advanced in 1967 with the building of a world-leading new Burns Centre. Salisbury NHS Foundation Trust s department of Plastic Surgery provides most types of Plastic Surgery and is also a regional centre for Cleft Lip and Palate, Burns and the Laser Service. These services cover a catchment population of approximately 3 million people across Hampshire, Dorset, Wiltshire, the Isle of Wight and the Channel Islands. The driving force and founder of the unit was Dr John Barron, a New Zealander by birth, who built an international reputation in his specialist field. Page 3
PIONEERING THEATRES 1966: Jeanne Yates (left) was the Theatre Superintendant who oversaw the new pioneering four-theatre unit at Odstock Hospital The two-table theatre system from the hutted military hospital, built for the US forces during World War 2, was in need of replacing for many years. One innovation, a first in the country, was in the circulation of air through the new suite. The most sterile area has the highest pressure supply so the air from that room can only move outwards. With forty air changes per hour, the air was filtered, warmed or cooled or humidified as necessary. Other innovations in the suite included a no hands intercom system, and the use of Bowie-type trays delivered to lay-up rooms through wall hatches fitted with sliding shelves. Fixtures, fittings and equipment cost 120,000 (equivalent to around 2million in today s money). Surgery performed in the unit was gynaecology, orthopaedic, children s general, oral facial, maxillary and plastic and reconstructive. About 4,500 operations were performed in 1966 Page 4
AN UNUSUAL FIRST... Cleft lip and palate operations were an important part of the workload for the Regional Plastic and Oral Surgery Centre at Salisbury. However, Dr J Laing (left) did what is thought to be the world s first such operation... on a horse in 1967. Theatre Superintendant at Odstock, Jeanne Yates, recalled that Dr Laing came up to her at the end of a session and asked her to bring her working gear for a little jaunt; she then jumped into his sports car and they whizzed along the country roads out to do a little job. Jeanne, somewhat mystified, found herself entering a stable at the home of Lord and Lady Russell. Dr Laing then performed the life-saving operation on a nine-week-old Palamino horse named Orodette. Picture the scene: the hay-strewn operating theatre being lit with a torch. The operation took about an hour and was a success. This paved the way for more operations in horses. A cleft lip or palate occurs when the structures that form the upper lip or palate fail to fuse together properly when a baby is developing in the womb. The causes may be genetic or environmental, although it is most often thought to be a combination of these factors. In most cases of cleft lip or palate, there is no recognisable cause. Read some inspiring stories and portraits from families using the Spires Cleft Lip and Palate Service at http://www.lookatme.salisbury.nhs.uk/index.htm Salisbury Journal article from 1967 that describes the historical operation performed by Dr Laing Page 5