History of Aseptic Technique

Ancient records show that antiseptics date far back into history; the ancient Chinese, Persians, and Egyptians had methods for water sanitation and antisepsis for wounds. The ancient Greeks and Romans used silver vessels to store fresh liquids and wine. Settlers in the Australian outback put silverware and Pioneers of the American West put silver and copper coins in drinking water to keep it fresh and prevent algae; settlers in the Australian outback put silverware in drinking water for the same purpose. Mercuric chloride was used to prevent sepsis in wounds by Arabian physicians in the Middle Ages. Hypochlorite and iodine were introduced as a treatment for open wounds in 1825 and 1839, respectively.

In 1861 Louis Pasteur proved that microorganisms caused spoilage and could be transported via the air. He placed broth in flasks with long S-shaped necks, then boiled the broth and observed that no microorganisms grew in the flasks. These experiments were the basis for the development of aseptic techniques. Pasteur showed that heat could kill microorganisms; this process was later named pasteurization.

Using the knowledge gained from Louis Pasteur, a scientist named Dr. Ignaz Semmelweis reduced the number of postpartum infections (puerperal sepsis) in the wards of Vienna’s lying-in hospitals by urging doctors to wash their hands between patients.

By the mid-nineteenth century, post-operative sepsis infection accounted for the death of almost half the patients who underwent major surgery. Later in the 1860’s, an English surgeon named Joseph Lister heard about Pasteur’s work. He began soaking his surgical dressings in carbolic acid (phenol) because he had heard the previous year that carbolic acid had been used to treat sewage in Carlise and the fields that had been treated were now free of parasite-causing disease. This led to a dramatic decrease in the number of post-operational infections. Before the discovery of antisepsis by Lister, about 80% of surgical patients contracted gangrene. In 1870, Lister’s antiseptic methods were used by Germany during the Franco-Prussian war, where they saved the lives of many Prussian soldiers. Although Germany and several other countries followed Lister’s procedure of sterilization, England and America were still in opposition to his “germ theory.” The turning point for Lister came on October 26, 1877, when he had the opportunity to perform a simple knee operation (wiring a fractured kneecap, which entailed deliberate conversion of a simple fracture into a compound fracture), which often resulted in generalized infection and death. News of this operation was widely publicized; its success forced people to accept that his methods greatly added to the safety of operative surgery. The culmination of his emphasis on the principle of preventative medicine was the opening of the Institute of Preventative Medicine in 1891. These are a few of the reasons why Joseph Lister is often referred to as the “father of antiseptic surgery.”

Paul Ehrlich, a German scientist, later advanced the idea of using chemicals to kill microorganisms by testing many more compounds. He eventually found a chemical that was successful against syphilis.

Another scientist that had a significant impact on the field of sterilization was Ernst von Bergmann. He is credited with introducing steam sterilization under pressure for treating instruments and all other medical equipment used for a surgical patient.

A famous surgeon from John Hopkins, William Stewart Halsted, introduced sterile rubber gloves to the field of medicine when his fiancée’s hands became irritated from constant washings and antiseptics.

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