Surgical antisepsis in Russia: historical parallels

Abstract

The origins of surgery and the improvement of surgical practices did not always guarantee a favorable surgical outcome. Even a masterfully performed operation could lead to a purulent-inflammatory process. Even at the stage of empirical development of medicine, before the great microbiological discoveries, an understanding was formed about a certain “substrate” that penetrates the surgical wound from the external environment and causes its suppuration. Supporters of the contagionist theory called it contagium, and supporters of the miasmatic theory considered the external (air) environment as such a source. The ideas of the supporters of the contagionist theory of the occurrence of purulent-septic complications in surgery in the middle of the 18th century are reflected in the works of D.S. Samoilovich and I.F. Semmelweis; the latter proved the transmission of the infectious principle by the surgeon’s hands, which became the starting point for the development of preventive antiseptics.

In historical retrospect, the technology and means used for surgical hand antisepsis in Russia were analyzed from the mid-18^th to the early 20^th centuries.

Moreover, literary sources for the period from 1783 to 2023 were analyzed, containing information about the antiseptic treatment of surgeons’ hands. Historical, descriptive, evaluative, analytical, and bacteriological research methods were used. As an experiment, the original antiseptic recipe described by D.S. Samoilovich (1783) was restored, and its effectiveness was confirmed.

During surgical practices in Russia, starting from the mid-18^th century, facts about the use of drugs with antiseptic activity for hand treatment are described. It is shown how, in historical retrospect, views on the final result of surgical antisepsis changed: from partial to complete destruction of microorganisms, preventing their entry from the deep layers of the skin, to the destruction of transient microflora and reduction of the abundance of resident microflora. Despite the influence of the English (J. Lister) and German (P. Fürbringer, J.F. Ahlfeld) surgical schools on the development of antiseptics in Russia, it retained its originality, determined by the needs of society and the possibility of using certain chemical antiseptics and their compositions for its implementation. The contribution of domestic surgeons to the improvement of antiseptic technologies and drugs in military field conditions is shown (N.I. Pirogov, A.M. Zabludovsky, D.I. Tatarinov et al.).

Keywords

surgical hand treatment / history of the issue / techniques / skin antiseptics / prevention of infections in the surgical area

References

[1] Lyubimova AV, Zueva LP, Golubkova AA, Tekhova IG. Hand hygiene of medical personnel. Federal clinical recommendations. Moscow; 2014. 31 p. (In Russ).

[2] Любимова А.В., Зуева Л.П., Голубкова А.А., Техова И.Г. Гигиена рук медицинского персонала. Федеральные клинические рекомендации. Москва, 2014. 31 с.

[3] WHO guidelines on hand hygiene in health care: a summary. Geneva: World Health Organization; 2013. 52 p. (In Russ).

[4] Руководство ВОЗ по гигиене рук в здравоохранении: резюме. Женева: Всемирная организация здравоохранения, 2013. 52 с.

[5] Niurka MÁ, Yudalvis OC. Conocimientos, actitudes y prácticas sobre la adherencia al lavado de manos en personal de salud. Revista Cubana de Pediatría. 2020;92(2):e938. (In Spanish)

[6] Niurka M.Á., Yudalvis O.C. Conocimientos, actitudes y prácticas sobre la adherencia al lavado de manos en personal de salud // Revista Cubana de Pediatría. 2020. Vol. 92, N 2. P. e938.

[7] Tanner J, Dumville JC, Norman G, Fortnam M. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev. 2016;2016(1):CD004288. doi: 10.1002/14651858.CD004288.pub3

[8] Tanner J., Dumville. J.C., Norman G., Fortnam M. Surgical hand antisepsis to reduce surgical site infection // Cochrane Database Syst Rev. 2016. Vol. 2016, N 1. P. CD004288. doi: 10.1002/14651858.CD004288.pub3

[9] Weber WP, Reck S, Neff U, et al. Surgical hand antisepsis with alcohol-based hand rub: comparison of effectiveness after 1.5 and 3 minutes of application. Infect Control Hosp Epidemiol. 2009;30(5):420–426. doi: 10.1086/596772

[10] Weber W.P., Reck. S., Neff U., et al. Surgical hand antisepsis with alcohol-based hand rub: comparison of effectiveness after 1.5 and 3 minutes of application // Infect Control Hosp Epidemiol. 2009. Vol. 30, N 5. P. 420–426. doi: 10.1086/596772

[11] Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev. 2004;17(4):863–893. doi: 10.1128/cmr.17.4.863-893.2004

[12] Kampf G., Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs // Clin Microbiol Rev. 2004. Vol. 17, N 4. P. 863–893. doi: 10.1128/cmr.17.4.863-893.2004

[13] Methodological guidelines “Prevention of infections in the surgical area”. Smolensk: NASKI; 2023. (In Russ.)

[14] Методические руководства «Профилактика инфекций области хирургического вмешательства». Смоленск: НАСКИ; 2023. 75 с.

[15] Samoïlowitz D. Mémoire Sur La Peste, Qui, En 1771, Ravagea l’Empire de Russie, Sur-Tout Moscou, La Capitale. Paris; 1783. (In French)

[16] Samoïlowitz D. Mémoire Sur La Peste, Qui, En 1771, Ravagea l’Empire de Russie, Sur-Tout Moscou, La Capitale. Paris, 1783.

[17] Weekly news of the Free Economic Society. Saint Petersburg: Tipografiya Gornogo uchilishcha; 1788. (In Russ.)

[18] Еженедельные известия Вольного экономического общества. Санкт-Петербург: Типография Горного училища, 1788.

[19] Semmelweis I. Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers. Hartleben: Pest-Viden-Lipsko; 1861. 543 S. (In German)

[20] Semmelweis I. Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers. Hartleben: Pest-Viden-Lipsko, 1861. 543 S.

[21] Pachner F. For the life of mothers. Moscow: Gosudarstvennoe izdatel’stvo medicinskoj literatury; 1963. 223 p. (In Russ.)

[22] Пахнер Ф. За жизнь матерей. Москва: Государственное издание медицинской литературы, 1963. 223 с.

[23] Lister J. On the antiseptic principle in the practice of surgery. The Lancet. 1867;90:353–356.

[24] Lister J. On the antiseptic principle in the practice of surgery // The Lancet. 1867. Vol. 90. P. 353–356.

[25] Breydo IS. History of antiseptics and asepsis in Russia. Leningrad: Gosudarstvennoe izdatel’stvo medicinskoj literatury; 1956. 196 p. (In Russ.)

[26] Брейдо И.С. История антисептики и асептики в России. Ленинград: Государственное издательство медицинской литературы, 1956. 196 с.

[27] Pirogov NI. The beginnings of general military field surgery, taken from observations of military hospital practice and memories of the Crimean War and the Caucasian expedition. Dresden: Tipografiya E. Blokhmana i syna; 1866. (In Russ.)

[28] Пирогов Н.И. Начала общей военнополевой хирургiи, взятыя изъ наблюденiй военногоспитальной практики и воспоминанiй о Кримской войнъ и кавказской экспедицiи. Дрезден: Типография Э. Блохмана и сына, 1866.

[29] Bolshesolskij PK. On the question of the comparative effect of bicarbonate and bichloride mercury as antiseptics [dissertation]. Saint Petersburg; 1887. (In Russ.)

[30] Большесольский П.К. Къ вопросу о сравнительномъ дъйствiи двуiодистой и двухлористой ртути какъ антисептическихъ средствъ: дис. ... д-ра мед. наук. Санкт-Петербург, 1887.

[31] Zabludovsky AM. On some new methods of disinfection of hands and the operating field. Moscow: Tovarishchestvo skoropechatni A.A. Levenson; 1911. (In Russ.)

[32] Заблудовский А.М. О некоторых новых способах обеззараживания рук и операционного поля. Москва: Товарищество скоропечатни А.А. Левенсон, 1911.

[33] Chirikov AV. Practical importance of hand sanitization methods [dissertation]. Saint Petersburg; 1898. (In Russ.)

[34] Чириков А.В. Практическое значенiе способовъ обеззараживанiя рукъ: дис. ... д-ра мед. наук. Санкт-Петербург, 1898.

[35] Akatsatov NE. On the issue of the provision of hands [dissertation]. Saint Petersburg; 1901. (In Russ.)

[36] Акацатов Н.Е. К вопросу об обеспложивании рук: дис. ... д-ра мед. наук. Санкт-Петербург, 1901.

[37] Great Medical Encyclopedia. Moscow: Sovetskaya entsiklopediya; 1974–1989. (In Russ.)

[38] Большая медицинская энциклопедия. Москва: Советская энциклопедия, 1974–1989.

[39] Levshin LL. On the use of various methods and means for disinfection in surgery. Moscow: Universitetskaya tipografiya; 1898. (In Russ.)

[40] Левшин Л.Л. О применении в хирургии различных способов и средств для обеззараживания. Москва: Университетская типография, 1898.

[41] Zabludovsky AM. Introduction to the surgical clinic. Moscow: Gosudarstvennoe izdatel’stvo; 1922. (In Russ.)

[42] Заблудовский А.М. Введение в хирургическую клинику. Москва: Государственное издательство, 1922.

[43] Gegner C. Über einige Wirkungen des formaldehyds. dis. doktorwürde. Erlangen; 1893. (In German)

[44] Gegner C. Über einige Wirkungen des formaldehyds. dis. doktorwürde. Erlangen, 1893.

[45] Ahlfeld F. Lehrbuch der geburtshilfe zur wissenschaftlichen und practichen ausbildung ärzte und studierende. Leipzig: Verlag von fr. Wilh Grunow; 1898. (In German)

[46] Ahlfeld F. Lehrbuch der geburtshilfe zur wissenschaftlichen und practichen ausbildung ärzte und studierende. Leipzig: Verlag von fr. Wilh Grunow, 1898.

[47] Fürbringer P. Untersuchungen und vorschriften über die desinfektion der hände des arztes nebst bemerkungen über den bakteriologischen character des nagelshmutzes. Weisbaden: Verlag von J.F. Bergmann; 1888. (In German)

[48] Fürbringer P. Untersuchungen und vorschriften über die desinfektion der hände des arztes nebst bemerkungen über den bakteriologischen character des nagelshmutzes. Weisbaden: Verlag von J.F. Bergmann, 1888.

[49] Popovich DA. Comparative evaluation of various methods of disinfection of hands and the operating field based on the principle of tanning [dissertation]. Saint Petersburg; 1910. (In Russ.)

[50] Попович Д.А. Сравнительная оцънка различныхъ способовъ дезинфекцiи рукъ и операцiоннаго поля, основанныхъ на принципъ дубленiя : дис. ... д-ра мед. наук. Санкт-Петербург, 1910.

[51] Oppel VA. History of Russian surgery: A critical essay. Vologda: Izdanie Vologodskogo oblastnogo otdeleniya gosudarstvennogo izdatel’stva; 1923. (In Russ.)

[52] Оппель В.А. История русской хирургии: критический очерк. Вологда: Издание Вологодского областного отделения государственного издательства, 1923.

[53] Melnik DA, Mendaeva AM, Gilmiyarova VO, et al. Plague and COVID-19. Retrospective parallels after 250 years. Nauchnyj medicinskij vestnik Yugry. 2023;(2):187–188. (In Russ.) doi: 10.25017/2306-1367-2023-36-2-187-188

[54] Мельник Д.А., Мендаева А.М., Гильмиярова В.О., и др. Чума и COVID-19. Ретроспективные параллели спустя 250 лет // Научный медицинский вестник Югры. 2023. № 2. С. 187–188. doi: 10.25017/2306-1367-2023-36-2-187-188

[55] Kratkoe opisanie mikroskopicheskih izsledovanij o sushchestv yadu yazvennago, kotoryya proizvodil v Kremenchug Danilo Samojlovich. Saint Petersburg: Tipografiya P.B.; 1792. (In Russ.)

[56] Краткое описанiе микроскопическихъ изследованiй о существъ яду язвеннаго, которыя производилъ въ Кременчугъ Данило Самойловичъ. Санкт-Петербургъ: Типография П.Б., 1792.

[57] Samoilovich D. Selected works. Moscow: AMN; 1952. 492 p. (In Russ.)

[58] Самойлович Д. Избранные произведения. Москва: АМН, 1952. 492 с.

[59] Krasilnikov AP. Handbook of antiseptics. Minsk: Vyshejshaya shkola; 1995. 367 p. (In Russ.)

[60] Красильников А.П. Справочник по антисептике. Минск: Вышэйшая школа, 1995. 367 с.

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