page_title: History of surgery
section_title: Antiseptic surgery
hierarchical_section_title: History of surgery / Modern surgery / Antiseptic surgery
caption_attribution_description: English: Joseph Lister, 1st Baron Lister (5 April 1827 – 10 February 1912)
context_page_description: Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment. Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature."
  Since humans first learned to make and handle tools, they have employed their talents to develop surgical techniques, each time more sophisticated than the last; however, until the industrial revolution, surgeons were incapable of overcoming the three principal obstacles which had plagued the medical profession from its infancy — bleeding, pain and infection. Advances in these fields have transformed surgery from a risky "art" into a scientific discipline capable of treating many diseases and conditions.
context_section_description: The introduction of anesthetics encouraged more surgery, which inadvertently caused more dangerous patient post-operative infections.  The concept of infection was unknown until relatively modern times. The first progress in combating infection was made in 1847 by the Hungarian doctor Ignaz Semmelweis who noticed that medical students fresh from the dissecting room were causing excess maternal death compared to midwives. Semmelweis, despite ridicule and opposition, introduced compulsory handwashing for everyone entering the maternal wards and was rewarded with a plunge in maternal and fetal deaths, however the Royal Society dismissed his advice.
  Until the pioneering work of British surgeon Joseph Lister in the 1860s, most medical men believed that chemical damage from exposures to bad air (see "miasma") was responsible for infections in wounds, and facilities for washing hands or a patient's wounds were not available. Lister became aware of the work of French chemist Louis Pasteur, who showed that rotting and fermentation could occur under anaerobic conditions if micro-organisms were present.  Pasteur suggested three methods to eliminate the micro-organisms responsible for gangrene: filtration, exposure to heat, or exposure to chemical solutions. Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop antiseptic techniques for wounds.  As the first two methods suggested by Pasteur were inappropriate for the treatment of human tissue, Lister experimented with the third, spraying carbolic acid on his instruments. He found that this remarkably reduced the incidence of gangrene and he published his results in The Lancet.
   Later, on 9 August 1867, he read a paper before the British Medical Association in Dublin,  on the Antiseptic Principle of the Practice of Surgery,  which was reprinted in The British Medical Journal. His work was groundbreaking and laid the foundations for a rapid advance in infection control that saw modern antiseptic operating theatres widely used within 50 years.
  Lister continued to develop improved methods of antisepsis and asepsis when he realised that infection could be better avoided by preventing bacteria from getting into wounds in the first place. This led to the rise of sterile surgery. Lister instructed surgeons under his responsibility to wear clean gloves and wash their hands in 5% carbolic solution before and after operations, and had surgical instruments washed in the same solution. He also introduced the steam steriliser to sterilize equipment. His discoveries paved the way for a dramatic expansion to the capabilities of the surgeon; for his contributions he is often regarded as the father of modern surgery. These three crucial advances - the adoption of a scientific methodology toward surgical operations, the use of anaesthetic and the introduction of sterilised equipment - laid the groundwork for the modern invasive surgical techniques of today.
  In the late 19th century William Stewart Halstead (1852–1922) laid out basic surgical principles for asepsis known as Halsteads principles. Halsted also introduced the latex medical glove. After one of his nurses suffered skin damage due to having to sterilize her hands with carbolic acid, Halsted had a rubber glove that could be dipped in carbolic acid designed.
caption: Joseph Lister, pioneer of antiseptic surgery.
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