Where will it all come from?
Supply sources for all of these developments will end up spread across the USE and into the Union of Kalmar. Secondary sources will develop in the Lowlands, Padua and Venice, and France. In canon, we already have Lothlorien Farbenwerks (initially cannabis[vii], but later dyes and their derivatives); Manning's Medical Manufacturing (3M)[viii] (the providers of insulin among other medications); Daisy Matheny BioLabs (the re-developers of tetanus toxiod[ix], as well as other immunizations); Essen Chemical, (one of the first producers of chloramphenicol, HTH (calcium hypochlorite-used for water purification); gamma hexane hexachloride (one of the safest effective synthetic insecticides), and sulfanilamide[x] outside of Grantville). Other sources include The Antonites, a Franciscan monastery, (producers of decent crude penicillin from a mashed pea soup with a trace of borax[xi] after obtaining their initial culture material from Grantville); and several steel makers. One of the more important people working to provide steel will be Louis de Geer (1587-1652), who controlled much of the Swedish steel production[xii] and who is working closely with Essen Steel. The first imports of chromium could not arrive before the fall of 1635, and more likely sometime in mid to late 1636, from the mines in Maryland. Despite the amazing amount of down-time brainpower that can be brought to bear on the problem, it will be decades before some of the more exotic alloys, including titanium, will be available.
The various orthopedic pins and wires will be easy once high-quality stainless steel is available, as they are pulled in wire mills, and then threaded if needed. It will take some experimentation for the blacksmiths and instrument makers to get the surgical instruments correct. They will probably start with the scalpel handles, then larger clamps, then scissors, and finally the smaller clamps as their techniques improve. Most of the clamps use "box" hinges, where one part fits inside a "box" formed in the middle of another. This is the reason I expect master instrument-makers being associated with each of the New Model medical schools and with the larger New Model teaching hospitals.
As I recall, carbon steel needles in the early modern era were some of the more expensive items that a woman or tailor could own prior to the RoF; and those needles were rather larger than most of the ones used in surgery[xiii]. Add in that the swaged-on models can't be reused, and the cost of needle making will have to drop substantiallybefore the swaged-on models become practical.
It does help that some form of needle making (to support the growing sewing machine industry) is effectively in canon, even if I can't recall it being directly mentioned.
Duct tape but not bailing wire.
Another item that will be in short supply will be sticky tape, especially tape safe to use on human skin. While there are many field expedients (ripped petticoats come to mind) to bind dressings[xiv] to the victims, and many other type of non-adhesive bandages (in addition to rolls of gauze, and triangles of linen called cravats, Dr. Scultetus was credited with the development of the "many tailed abdominal bandage" that bears his name to this day) in OTL, surgical tape was not developed until the late 1800s, after the development of rubber-based adhesives. Adhesive bandages (Band Aid ™ brand bandages or British "sticking plasters"), with the dressing (a sterile gauze pad) already attached to a strip of tape, were not developed until the 1920s. By CE 2000, there were a wide variety of tapes, including many that could be directly applied to wounds as a form of closure (SteriStrips ™ were commonly used to replace sutures or staples after the first stages of healing have completed, reducing scarring). There is also a technique called "butterflying[xv]," where a strip of tape is cut one-third in from both sides, the edges folded back on themselves, and the central portion passed through a candle flame to sterilize it before the strip is applied to close the wound.
Once rubber-based adhesives are available, basic white surgical tape is a matter of mixing the adhesive with zinc oxide to reduce the growth of bacteria and modify the "tackiness." The mixture is then spread along a length of tightly woven, light- weight canvas duck material, and allowed to dry slightly, before being rolled on a wooden or cardboard form. This produces the familiar "sticky tape" that was the standard for securing dressing until the mid 1970s, when more advanced forms (with improved adhesives and lighter, sometimes even non-woven, fabrics became available. This old-fashioned adhesive tape is now mostly relegated to protective taping of athletes, and to improve grips on tools and sporting goods.
How will Grantville influence the development of trauma care and surgery in the New Time Line (NTL)?
The three most important contributions to surgical care that Grantville brings back are the "Germ Theory of Disease," the idea of controlled anesthesia, and 350 years of surgical history. The first leads to propagating aseptic (without infection) surgery methods, which is the first and most important method of preventing needless postoperative complications and death. The second allows the surgeon to operate meticulously when needed, rather than concentrating on speed. By the 1630s, there are already skilled surgeons who can remove a leg above the knee in less than five minutes, but the survival rate of their patients is dismal. Those same surgeons, operating aseptically, and with the advantages of controlled anesthesia, will probably take more than four times as long to remove a leg, but most of their patients will survive the surgery and potentially even thrive. Add in the descriptions of the most important of the 350 years of up-time developments and the open abdominal surgeries already in canon, and the science of surgery will take off in the late 1630s as it did in the 1920s in OTL. The major limitation to surgical advances between 1631 and the late 1630s will be the need to develop the supporting infrastructure, including building hospitals with aseptic operating rooms, creating and producing the needed instruments and redeveloping other materials, including sutures, antiseptics and anesthetics.
Those novel (to the down-timers) techniques will include such procedures as the development of a skin and muscle flap to close the stump of an amputation, bowel resections and colostomies for trauma and cancer, and tracheotomies and the use of chest tubes for the relief of ventilation problems in trauma, cancers or certain diseases. As the technology catches up, there will be a second expansion of surgical techniques, including cardiac and brain surgery, in the late 1640s and 50s, much like that seen in the 1950s and 1960s in OTL.
Aseptic Techniques developed out of the Germ Theory.
Prior to the medical establishment's understanding that there were organisms that caused disease, and those miniscule organisms could be transmitted between the sick and well by instruments, contaminated dressings, and even the very clothing and hands of the physicians and nurses, infections were commonplace consequences of medical care. Before the development of aseptic techniques, any surgery or even much of basic medical care, created almost as much a chance of a nasty death as a wound in combat. Aseptic techniques will cover the operations themselves, the care of the patient afterwards, and just as importantly, the care of the operating instruments themselves.
In OTL, there were several champions of cleanliness in health care. Beginning with Ignaz Philipp Semmelweis in Vienna, and Florence Nightingale in Great Britain, both in the middle of the 1800s, devotees of medicinal cleanliness included Joseph, Baron Lister in Great Britain, Louis Pasteur in France, and Robert Koch and Friedrich Loeffler in Germany in the later years of that century.