Surgery Antiseptics Revision Cards SWHS

The development of antiseptics followed the discovery of anaesthetics at a time where deaths were increasingly high. This was due to doctors performing more complex operations because of the new found anaesthetics. However, they couldn't workout the problem of infection that spread in hospitals. Before the breakthroughs people had limited knowledge about germs and how they spread. Therefore, at the time doctors didn't know how to apply this to surgery or in the treatment of patients.

Key Content:

• Florence Nightingale
• Ignaz Semmelweiss
• Joseph Lister - Carbolic Acid
• Change in Surgery

Florence Nightingale

In Crimea she worked as a nurse in the battlefields, where the conditions typically consisted of dirty sheets and unsanitary wards. The food given to patients was scarce and the men had no privacy in the wards. She had had previous training in Germany which proved that her theory of poor nursing and inadequate conditions had a regressive impact on the health of patients. She insisted their be very high standards among her nurses and that each bed should only hold one person.

• Her work led to 50 percent decrease in army hospital death rates which was a huge problem faced at the time.
• Publicity helped her open the first school for nursing in Britain in 1861.
• The role of nurses was vlaued for highly in hospitals.

Ignaz Semmelweiss

In 1846, he noticed that whilst giving birth women who where attended by a midwife were less likey to die from infection than those being treated by a medical student. His work demonstrated that hand washing drastically decreased the amount of women dying after child birth.  He found that the students who attended births often came from dissecting dead animals spreading the harmful bacteria around hospitals.

To stop the antibiotic-resistant strains of bacteria multiplying we now know that handwashing is essential. Hospitals now are supplied with antiseptic hand gel which both visitors and doctors use for before seeing patients vulnerable to infection.

Before, the late 1800s surgeons didnt scrub their hands to free them from bacteria, this allowed microbes to be passed from one patient to another. Dissecting animals was common and doctors would often return the mothers after this without washing their hands which consequently led to women dying from 'childbed' fever.

Joseph Lister

He discovered that Carbolic Acid reduced infection and promoted antiseptic conditions in surgery.

He was a surgeon and had read about Pasteur's germ theory which was published in 1861. Carbolic Acid was used in sewers to kill parasites and so Lister decided to use it on the microbes that caused infection. He tested his findings on a boy with a broken leg. He soaked bandages with the acid and within six weeks the wound had healed cleanly. He started to wash his equipment and hands in the acid and treated the air with carbolic spray during operations. Blood poisoning was very common at the time of Lister's dsicovery, which was caused by deadly microbes in the air. The death rate dropped dramatically and he announced no one had died from blood poisoning for 9 months in 1897. He also intorduced catgut  which was used to stitch wounds instead of silk as it could be sterilised. He developed a type of catgut that dissolved inside the body which didnt need to be removed.

Change in Surgery

Many people criticised Listers's work. They didnt believe that the corrosive carbolic acid would really help progress surgery. However, his determination meant that antiseptic surgery was commonly used by the 1890s Eventually this led to aseptic surgery where bacteria was prevented rather than destroyed.

Hospital cleanliness was at its highest and all insruments used in surgical operations were sterilised in boiling water or steam. Sterile clothing, face masks and rubber gloves were also intorduced and worn during operations by doctors and occupants inside the operating theatre. 

Key Terms:

• Gangrene - the infection of dead tissue causing foul smelling gas.
• Sepsis - also known as blood poisoning. The body is overwhelmed with infection and so it often causes death.
• Antiseptics - chemicals used to destroy bacteria and prevent infection.
• Antiseptic Surgery - killing germs in wounds.
• Aseptic Surgery - removing germs from the operating theatre