NIKOLAY PIROGOV

THE INNOVATIVE SURGEON WHO ENDORSED ANAESTHETICS, PLASTER CASTS, NURSES AND THE TRIAGE SYSTEM 1810-81 RUSSIA

Pirogov was a Moscow surgeon who became a professor of military surgery. During the Caucasian War he studied the effects of firearms injuries and introduced disarticulation of joints and resection of bones to save limbs instead of having them amputated. He also followed work by French surgeon Louis-joseph Seutin that introduced plaster casts to set broken bones.

During the Crimean War, Pirogov became the leading exponent of anaesthesia in Russia and used it at the Siege of Sevastopol. As head of the Russian Army medical services, he regarded war as a traumatic epidemic where successful treatment of mass casualties required good management as well as surgical skill. Pirogov supported the deployment of female nurses and surgical assistants who worked under shellfire and became known as the ‘Sisters of Mercy’. He also introduced the triage system where casualties were classified into four groups depending on the degree of injuries. This was the first ever use of triage in the management of mass casualties.

One of Pirogov’s most famous innovations was a new osteoplastic method for foot amputations, which became known as the ‘Pirogov amputation’