An illuminating and occasionally gruesome lecture for a non-medic unused to the visual realities of war, the third of the series UCL Lunch Hour Lectures on Tour marking the centenary of the First World War tackled a rarely discussed aspect of the aftermath of trench warfare.

Henry Tonks, Portrait of a Wounded
Soldier Before Treatment
Credit: UCL Art Museum

The idea of the fabrication of living tissues to repair injuries is well publicised in the media today, from growing an ear on the back of a mouse, to full face transplants.

However, the development of reconstructive techniques was largely precipitated by the industrial scale of conflict in WW1.

Sadly, Professor Robert Brown (UCL Surgical Science) was unable to attend, so we were left in the capable hands of Colin Hopper (UCL Eastman Dental Institute) who delivered both the historical and medical sides of the lecture with distinctive candour.

Early medical advances

I was unconvinced that a GCSE in Biology would get me through the finer points of tissue fabrication, so it was a relief that we began with the historical context of medical advances during military conflicts since the early 1800s.

The fact that disease was responsible for a large number of deaths during the wars between 1804-15 was hardly a surprise, but the scale of the death–nearly 266,000 of the 311,806 deaths (85%) in the Army and Navy–showed just how much of an impact developments in medicine made to survival rates in future conflicts.

Changes in strategy and weaponry in WW1 caused a significant increase in the number of soldiers who sustained head and limb injuries, yet over 92% of wounded British soldiers evacuated to British medical camps survived. Some fairly horrific slides of facial injuries from more recent Iraqi and Libyan conflicts demonstrated the consequences of the types of weaponry used a hundred years earlier. Major General Henry Shrapnel has a lot to answer for.

As a head and neck surgeon, Colin was interested to know how much the audience thought a person needed of their face to survive. Drawing a line running from the top of the head and behind the ears with his hand, he revealed that anything below that line is an “optional extra”–who needs frontal lobes?

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Written by Emily Burns, who attended a lecture by Professor Martin Birchall (UCL Ear Institute) at the Cheltenham Science Festival, entitled ‘Regenerative Medicine: Where will we be in 50 years?’

Mouse heart showing position of coronary arteries.

What happens if a newt’s leg is cut off? Or a gecko’s tail auto-amputated?

The cells simply multiply to grow back into exactly what was missing. If a flatworm were cut in two, the two halves would both become new flatworms.

Unfortunately for humans, this incredible ability to self-regenerate was lost several branches ago on the evolutionary tree. As such, we definitely don’t have the ability to grow a new leg, or a new heart.

We have to rely on skin grafts and organ transplants, with common risks of rejection, infection and multiple complications. However, according to Professor Mark Birchall and Dr Felicity Mehendale, our regenerative future is just around the corner.

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On 23 April, a collection of researchers, medical professionals, patients and members of the general public congregated at the Royal Free Hospital for an afternoon of enlightenment and discussion.

The Rt Hon. Adrian Bailey MP opened the conference, revealing that three people die each day in the UK waiting for an organ transplant. This highlighted the importance of the situation, explaining why the shortfall in donor organs needs to be addressed urgently.

Session 1: Pathway of Transplantation, Donation and Research
Professor Brian Davidson (UCL Division of Surgery and Interventional Science) was tasked with providing “a brief history of transplantation, organ donation and research”. He managed to offer a comprehensive overview, focusing on the dramatic improvements in organ transplantation since the 1970s.

Professor Davidson was clear, however, that there are still necessary advancements to be made. He mentioned the disparity between donation rates across Europe – the rate in the UK is half that of Spain.

Possible solutions to bridge the gap were explored, such as surgical innovation (splitting donor organs and live donor transplants), xenotransplantation and tissue engineering.

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