NIKOLAY PIROGOV

History of War - - CRIMEAN WAR -

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’

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