surgery

• 19th century

  infection:

  • audience of trainees
  • no gloves, no masks, no gowns
  • unsterilised equipment

  blood loss

  pain:

  • death from shock - patient aware
  • movement
  • quick opperations
• how was the problem of pain solved (totally)

  • nitrous oxide - numbed the pain for SMALL operations
  • 1842-46 = ether - Robert Liston used before amputating a leg - but it irritated lungs -> cough -> dangerous(movement) also explosive
  • James Simpson - chloroform
• how was the problem of infection solved (totally)


  longer operations = higher rick of infection

  before 1860 (+acceptance of germ theory) surgeons had no precautions to infections - reused bandages, didn't wash hands, wore dirty clothes and had an audience in operating theatres
• how was the problem of infection solved (totally)


  Joseph Lister-

  • surgeon in 19th century
  • researched infection
  • used new scientific developments to improve medicine
  • CARBOLIC ACID - treated sewage -> decided to spray on wound during surgery and then used a clean bandage (dipped in carbolic acid) -- this decreased infection rate and increased survival
• carbolic acid - opposed


  it burnt surgeons hands

  unpleasant to work with

  Lister couldn't explain why it worked
• how was the problem of infection solved (totally)


  1890 - aseptic surgery -> instead of killing the bacteria, stop it getting into the body.

  1900 - steralise equipment, operating theatres = spotless, surgeons wore gloves, gowns and masks
• once koch discovered bacteria caused blood poisoning LISTERS IDEAS WERE TAKEN SERIOUSLY

  he changed surgery because:

  • he changed surgeons attitudes to aseptic(no germs) and antiseptic(kill germs) surgery
  • rubber gloves, masks and gowns were introduced
  • instruments and operating theatres were cleaned
• Bleeding


  STILL A PROBLEM

  surgeons still needed to know how to:

  • stop bleeding
  • replace blood
  • find out about blood types
  • how to store blood

  (20th century)
• joseph lister used carbolic acid as an antiseptic which reduced infection rates during surgery