Antiseptics

• Antiseptics


  Anaesthetics had solved the problem of pain, but surgeons were still faced with a high death rate from operations due to the amount of infection. Antiseptics and later asepsis helped prevent this by killing germs
• Antiseptics


  Substances used to prevent infection
• The hand washing method was very unpleasant, so wasn't widely used
• Lister's use of antiseptics

  1. Saw carbolic acid sprays used in sewage works to keep down the smell

  2. Tried this in the operating theatre in the early 1860s

  3. Saw reduced infection rates
• Lister heard about the Germ Theory in 1865
• Lister's use of antiseptics

  1. Realised that germs could be in the air, on surgical instruments and on people's hands

  2. Started using carbolic acid on instruments and bandages
• Use of antiseptics


  Immediately reduced death rates from as high as 50% in 1864-66 to around 15% in 1867-70
• Use of antiseptics


  Allowed surgeons to operate with less fear of patients dying from infection
• The number of operations increased tenfold between 1867 and 1912 as a result
• Comment and Analysis


  Antiseptics (and later asepsis) solved the problem of infection. This, combined with the use of anaesthetics to stop pain, improved British surgery - many deaths were prevented as a result of antiseptics and anaesthetics
• Asepsis


  Making a germ-free (aseptic) environment
• Surgeons changed their approach from killing germs to making a germ-free (aseptic) environment


  Late 1800s
• Sterilising instruments


  Carefully sterilised before use, usually with high temperature steam (120C)
• Sterilising theatre staff


  1. Sterilise their hands before entering

  2. Wear sterile gowns, masks, gloves and hats
• Surgical gloves


  Invented by William Halsted in 1889
• Maintaining sterile theatre environment

  1. Kept scrupulously clean

  2. Fed with sterile air

  3. Special tents can be placed around the operating table to maintain an area of even stricter hygiene in high risk cases
• Aseptic surgery


  Reduced the need for a carbolic spray, which is unpleasant to get on your skin or breathe in
• Many doctors and nurses didn't like to use carbolic spray