Scientist Spotlight: Joseph Lister and Sterile Surgery

"Prepare for decontamination."
Monsters Inc., Pixar Studios

Even this guy knows about aseptic technique...
Nowadays, it's common practice for nurses and doctors to operate within a sterile environment1. Scrubs and operating tools must be sterilized to prevent any kind of infection or contamination. However, these practices did not become standard until the late 1860s.
Joseph Lister was born in 1827 in Essex, England. He attended University College, London, where he initially focused on botany before going on to the Royal College of Surgeons2. Prior to Lister’s revelations, the prevailing thought in hospitals was that exposure to air and its chemicals caused infections in patients’ wounds. As a result, hospital wards would often air out in the middle of the day in an attempt to get rid of the bad air. This bears some similarities with misinformed thoughts on malaria at the time (which was literally derived from the term mala aria, or bad air).
As surgeons blamed the air for wound infections, they were not required to wash their hands or clean their operating gowns. In fact, some surgeons operated in their regular street clothes. Whatever the surgeon chose to wear, their outfits were not washed. Dirty operating clothes were considered to denote a surgeon’s expertise and experience. The operating rooms themselves were not sterile either. Surgical dressings were often scraps picked up from the floor of a cotton mill. Surgeons used sewing needles from their coats to close up wounds and would use the same needle on other patients. Needless to say, infection rates were incredibly high, while survival rates were very low. It’s no wonder most people tried to avoid surgery if at all possible3.
Lister was serving as a professor at the University of Glasgow when Louis Pasteur published influential articles stating that fermentation and food spoilage could happen even in anaerobic conditions. This immediately poked holes in the theory that miasma (a term for noxious or bad air) was causing wound infections. To remove microorganisms, Pasteur suggested filtration, exposure to heat or exposure to chemicals. Obviously, the first two methods wouldn’t work well on human patients, but the third was an option Lister began to consider.

Fire isn't always the best cleaning option.
The IT Crowd, Channel 4 TV.
Lister started to use phenol (also known as carbolic acid) as an antiseptic. Originally, carbolic acid was used to ease the stench of sewage-irrigated fields. He assumed it might be safe to use on humans because there were no observable problems with livestock that grazed in those treated areas. Lister began spraying operating tools, dressings, and incision/wound sites with a solution of carbolic acid. As soon as he implemented this protocol, gangrene and post-surgery infections decreased dramatically. Lister published his findings and began advocating the use of clean gloves and the washing of hands with 5% carbolic acid solutions before and after the surgery2.
Of course, Lister’s methods have been applied to surgical rooms everywhere, and he is now commonly known as “the father of modern surgery”. He even went on to advise doctors on antiseptic technique when they had to operate on King Edward VII of England. King Edward thanked Lister, saying, “I know that if it had not been for you and your work, I wouldn’t be sitting here today.”

Many things have taken their namesake from Lister. Image from the CDC.
Since then, Lister’s accomplishments have been celebrated and observed in many different ways2:
  • Listerine mouthwash was named after him.
  • Listeria, a pathological bacterial genus we discussed previously, was named after him as well.
  • The Lister Medal, given out by the Royal Society, is considered the highest honor that can be awarded to a surgeon.
  • A public monument honors him in London.
  • The British Institute of Preventative Medicine was renamed The Lister Institute.
Clearly, Lister’s improvements on aseptic technique has saved countless lives. The next time you take a trip to the hospital for a check-up or visit, be thankful that we’re now doing more than just “airing out the place”. Do you have any other scientists you’d like to see us shine the spotlight on? Let us know at tech@biolegend.com.
References:
  1. Aseptic Technique in Surgery
  2. Joseph Lister on Wikipedia
  3. Pasteur to Lister to Johnson

Just when I thought I got the hang of science...
Contributed by Ken Lau, PhD.
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