The Jugoslavian Connection

British plastic surgeons, and one in particular, were instrumental in starting plastic surgery in the former Yugoslavian republics.

At the end of World War II the people of then Yugoslavia, under the leadership of Josip Broz Tito had sustained one of the highest casualties rates per head of population in Europe. Hundreds of wounded made their way across the Adriatic from Yugoslavia to Italy where the British Maxillo-facial Unit No. 1 was stationed in Bari, Italy. They were under the command of plastic surgeon Major John Barron. No.1rapidly became overwhelmed with Yugoslavs, something which rapidly came to the attention of Harold Gillies back in Britain. Through government contacts, Gillies, arranged for relevant personnel and supplies to be sent to Belgrade under the auspices of the United Nations Relief and Rehabilitation Administration (UNRRA). From November 1945 until the autumn of 1946 four surgical teams went out to the Balkans in rotation. Each comprised a plastic surgeon, dental surgeon, anaesthetist, nurses, technicians and a secretary. Barron went with them.

They set up in a 100-bed hospital in Belgrade with very limited equipment and resources. Patients were nursed two to a bed at first. News of the unit produced an overwhelming flood of civilian and military casualties. The British began teaching and training comparable teams of Yugoslav surgeons and medical staff. Plastic surgery was entirely new to them. They finally returned to Britain leaving a fully equipped 110 bed hospital under the leadership of Professor Arneri.

This unit became the inception of plastic surgery in Yugoslavia. Surgeons from the six Balkan republics came to the unit in a “mammoth training effort” which was then disseminated throughout the whole country, rapidly gaining in quality of care. After only a short time it became obvious to John Barron and others that it would be valuable to offer the most senior Yugoslav surgeons more detailed training in Britain. In the years following, a number of Yugoslav surgeons and other doctors came to Britain for additional experience. Harold Gillies, Professor Kilner and Rainsford Mowlem all visited the country in the early 1950s, which persuaded the local authorities to give priority to the continued expansion of plastic surgery. John Barron even had the ear of Marshall Tito. One of the leading units was established in Ljubljana by Professors Derganc and Zdravic, who had both been to Britain for training. They essentially transplanted the “British way” of doing things into Yugoslavia.

Barron made many trips to the main centres in Yugoslavia over the next 30 years. In the 1970s he was instrumental in forming a specialist hand surgery unit in Ljubljana, not previously a sub-specialty in the region. This went on to become an internationally known unit. For his services to surgery in Yugoslavia Barron was honoured many times over, including the country’s highest honour, bestowed upon him by Marshall Tito. In recognition of his role the University of Ljubljana inaugurated the Barron Institute of Plastic Surgery in 1976.

Ljubljana and the unit in Belgrade rapidly came to the forefront of plastic surgery development in the postwar period. They became leaders at the cutting edge of microsurgery when it transformed reconstructive plastic surgery in the 1970s. Ljubljana also spawned the offshoot unit in Maribor from where Zora Janzecovic revolutionised burn care in the 1960s

Adapted from a paper for BAPS by John Barron.

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