London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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PLASTIC SURGERY UNIT.
Honorary Chief Surgeon—Sir Harold Gillies, C.B.E., F.R.C.S.(Eng.).
Plastic Surgeon—T. P. Kilner, M.B., B.S., F.R.C.S.(Eng.).
Assistant Plastic Surgeon—A. H. McIndoe, M.Sc., M.S., F.R.C.S.(Eng.).
(1) Hammersmith Hospital.
Report for the period from 1st January to 15th August, 1934
By Sir Thomas Carey Evans, M.C., M.D., F.R.C.S.(Eng.), L.R.C.P., Medical
Superintendent, Hammersmith Hospital.
The volume of work during the first eight months of this year has shown an
increase on the corresponding period for the year 1933.
During the eight months 97 patients were admitted, and upon them 167 operations
were performed. The conditions requiring treatment showed no relative
change as compared with those admitted in the previous years. A most satisfactory
point noted during this period was that the number of patients reaching completion
of their treatment became considerably greater, and now that the unit has been
established for three years, this should remain a more permanent state of affairs.
In other words, there has been a greater number of patients returning for their final
operative stage, after an interval of from 6 to 18 months to allow of complete convalescence.
Expansion of the unit was limited on account, firstly, of the probability of early
transfer of the work to another hospital, and secondly, of the demands made by general
surgery on the time of the medical officer in charge. In spite of this there were
times when almost the whole capacity of the available wards was utilised to the
exclusion of general surgical work. This, of course, was dealt with elsewhere in
the hospital. The maximum number of patients in hospital at one time was 40,
and this gives some indication of the demand for beds for this work.
Anaesthesia.—There was no great change in the methods employed, and the
results continued to be excellent. This is entirely due to the skill of the visiting consultants.
Speech training.—60 sessions were given, comprising 267 individual lessons.
During the latter part of the period the number of sessions per week became insufficient,
in view of the increased number of patients requiring tuition.
Records and museum.—Records continued to be kept on a large scale, but the
foundation of a museum was postponed until after the transfer.
Dental laboratory.—65 units of work were completed, exclusive of the necessary
adjustments.
(2) St. James' Hospital.
Report for the period from 15th August to 31st December, 1934,
By W. L. Maccormac, M.B., Ch.B., F.R.C.S.(Edin.), Medical Superintendent,
St. James' Hospital.
As the result of the removal of the unit from Hammersmith to St. James'
hospital, there was some dislocation of the routine. This was mainly due to the
fact that it was impossible to transfer the dental laboratory until 1st October ;
and, without prior dental treatment, a proportion of patients were unable to be admitted
for operation.
As the result of the transfer it was found possible to reconstitute the unit. The
medical officer who has been in charge of the patients at Hammersmith was relieved
of all other duties, and allowed to concentrate on plastic surgery alone. The patients
are segregated in " bays," and though increasing work makes the present accommodation
inadequate, every endeavour is made to keep all patients requiring treatment
under the charge of the same nursing staff. A staff nurse and one junior nurse were
allocated for plastic work only in both the male and female wards. As a result of
these measures the efficiency of the unit was immediately increased, and the volume
of work commenced to rise.
(75)