Archibald Hector McIndoe was a New Zealand-born surgeon whose pioneering treatment of burns victims during the Second World War revolutionised the field of plastic surgery.
Born in Dunedin on 4 May 1900, McIndoe graduated from the University of Otago Medical School in 1923. The following year he was awarded the first New Zealand fellowship to the prestigious Mayo Clinic in the United States. Over the next four years he earned a Master of Science degree and published several medical papers on chronic liver disease. When his fellowship ended in 1928 McIndoe was appointed an assistant surgeon at the Mayo Clinic, where he developed a reputation as a quick-thinking and skilled surgeon.
With his star on the rise McIndoe was encouraged to further his career in the United Kingdom. He moved to London in 1930. Opportunities were scarce, though, and after a period of unemployment he contacted a distant relative, fellow New Zealander Sir Harold Gillies, in an effort to secure work. Gillies – a noted plastic surgeon of the First World War – invited McIndoe to join his private practice and offered him a position in the plastic surgery clinic at St Bartholomew’s Hospital in London. Under Gillies tuition, McIndoe quickly became a leading figure in the field of plastic surgery.
Following the outbreak of the Second World War, McIndoe took up a position at Queen Victoria Hospital in East Grinstead, Sussex, where he established a Centre for Plastic and Jaw Surgery. The Centre treated airmen with facial disfigurements and serious burns. Many patients arrived with deep burns to their faces and hands caused by exploding aircraft fuel – an injury dubbed the ‘Hurricane burn’ by pilots and aircrew.
During the Battle of Britain, 35 horribly burnt fighter pilots were sent to McIndoe for treatment. Standard treatment for serious burns at this time was to cover the wounds with tannic acid – the idea being that this would dry out the affected area and allow the dead skin to be removed. Unfortunately, this process was extremely painful and left patients with extensive scarring. McIndoe was convinced there was a better solution. Noting that burnt pilots who bailed out into the sea were less scarred than others, he developed the practice of bathing patients in saline. This proved to be a much gentler treatment process, with the saline solution improving healing times and survival rates for patients with extensive burns.
As well as developing innovative treatments and surgical techniques, McIndoe recognised the importance of rehabilitation. He encouraged ‘his boys’ to form their own ‘Guinea Pig Club’ and made sure they retained their proud identity by wearing their service uniforms instead of hospital convalescent uniforms. Particular emphasis was placed on patients′ social reintegration back into normal life. ‘The Boss’ or ‘Maestro’, as McIndoe was known, would regularly join patients in social events inside the hospital, take them for out for drinks, and encourage them to get out into the community. The effect was amazing. Relationships between patients and nurses blossomed. Many went on to marry. Others met women from East Grinstead, a place the ‘guinea pigs’ referred to as ‘the town that never stared’.
McIndoe won international recognition for his pioneering work at Queen Victoria Hospital. Knighted in 1947, he took up farming in East Africa, where he helped establish the African Medical and Research Foundation (AMREF). Back in Britain he was also involved in founding the British Association of Plastic Surgeons (BAPS), and later served as its president.
Archibald McIndoe died on 11 April 1960, aged 59. He was cremated and his ashes were buried in the Royal Air Force church of St Clement Danes in London.
His legacy lives on in the Blond McIndoe Research Foundation, which was opened at the Queen Victoria Hospital in 1961 and continues to conduct research into treatments to improve wound healing.
By Gareth Phipps