Evolution of Surgical Sterilization Practices

Alongside many groundbreaking medical innovations lies the evolution of surgical sterilization. There was once a time where many infectious diseases and complications occurred after surgery, resulting in death to the patient. With newcoming practices arising, sterilizing surgical techniques, surgery has now become one of the safest options for saving a life. The development of sterilization practices transformed surgery from a high-risk, last-resort procedure into a routine and life-saving discipline.

In the early nineteenth century, surgery was performed without knowledge of microorganisms. Surgeons operated with bare hands and reused unclean instruments, believing infection resulted from “bad air” or an imbalance of bodily functions. Because of these unsafe practices, the mortality rate rose to over 50%, making surgery a last-minute option for patients in need. 

Things started to change when the germ theory of disease, founded by Louis Pasteur in the 1860s, was discovered. Pasteur found that microorganisms were responsible for infection, laying the scientific foundation for antisepsis and sterilization.

Building on Pasteur’s work, British surgeon Joseph Lister created the antiseptic surgery in 1867. He applied phenol to wounds and instruments to destroy germs, significantly reducing infection rates. Lister’s antiseptic method marked the first attempt to control infection and contamination during surgery. However, it relied on chemical disinfection rather than true sterilization and was often harsh on tissues and equipment, marking it unreliable and in some cases harmful to the patient.

By the late nineteenth century, the focus shifted from antisepsis, destroying harmful germs in the wound and equipment, to asepsis, preventing germ entry altogether by the discoveries of steam sterilization by Charles Chamberland in 1881. Surgical tools could now be sterilized efficiently using pressurized steam, a method still in use today. Surgeons began adopting sterilized gowns, gloves, and masks to maintain aseptic in the operating room.

In the twentieth century, new sterilization techniques emerged. Dry heat, ethylene oxide gas, and radiation sterilization created to accommodate instruments sensitive to moisture or high temperatures. Disposable surgical supplies were also created, reducing cross-contamination risks and improving efficiency. All these new emerging practices ensured safety among healthcare. 

In the twenty-first century, surgical sterilization continues to evolve alongside technology. From deadly surgeries from the pre-germ era to the precision of modern sterile technique, the evolution of surgical sterilization emphasizes surgeries transition to a more safe option for patients. 

by Sofia Bonilla at Incisionary

APA References

Centers for Disease Control and Prevention. (2023). Guideline for disinfection and sterilization in healthcare facilities. U.S. Department of Health and Human Services. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html

Huber, P. (2011). The birth of antiseptic surgery: Joseph Lister’s contribution to modern medicine. Journal of Medical Biography, 19(4), 181–187. https://doi.org/10.1258/jmb.2011.011001

McDonnell, G., & Burke, P. (2011). Disinfection: Is it time to reconsider Spaulding? Journal of Hospital Infection, 78(3), 163–170. https://doi.org/10.1016/j.jhin.2011.05.002

Rutala, W. A., Weber, D. J., & Healthcare Infection Control Practices Advisory Committee. (2008). New low-temperature sterilization technologies: Ethylene oxide, hydrogen peroxide gas plasma, and vaporized hydrogen peroxide. Infection Control and Hospital Epidemiology, 29(11), 993–1003. https://doi.org/10.1086/59186

Podgorny, K., & Makic, M. B. F. (2016). The history and evolution of infection prevention: Lessons for the future. Nursing Clinics of North America, 51(1), 13–25. https://doi.org/10.1016/j.cnur.2015.10.003