American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

“On the Shoulders of Giants”: Sir Joseph Lister

As we read reports in the press of antibiotic-resistant “superbugs,” I am reminded of Sir Joseph Lister.

Lister was a renowned English surgeon who is credited with developing the concept of antiseptic surgery. In doing so, he developed the principles of cleanliness that changed the face of medicine and surgical practice forever. Joseph Lister’s breakthroughs in antiseptic surgery saved millions of lives and paved the way to the advancement of modern surgical technique and infection control.

Lister’s Prevention of Infection

Sir Joseph ListerWhile he was a surgeon at Edinburgh Hospital, Lister observed that several patients who had undergone surgery had died from postoperative infection. During those times, surgeons were trained to believe that infections arose from within the wounds themselves. They never washed their hands or changed their blood-stained clothes, which were considered a status symbol and the mark of a “true surgeon.” Lister did not accept this dogma. He conducted numerous research projects and spent years researching how dangerous infections could perhaps be prevented. He followed strict sterile procedures by washing his hands after every operation. This approach, although scoffed at by many, led to a reduction in death rates from infections among patients at the hospitals in which his protocols were implemented.

Based on previous work by Louis Pasteur, Lister believed that infections could be eliminated by restricting air-borne germs from contaminating the wound. Upon learning that carbolic acid was used as a disinfectant in the sewers to kill parasites, Lister wondered if these compounds might be safe to disinfect skin. He began to use carbolic acid to clean his hands, instruments, and bandages before, during, and after surgery. In 1869, Lister invented a new technique by filling a pump sprayer with carbolic acid to be used in the operating room. Lister’s antiseptic proved beneficial to killing germs, and soon several hospitals adopted this antiseptic practice, ultimately saving countless lives. After demonstrating his successful antiseptic techniques in various London hospitals, this procedure was accepted worldwide. Lister also proved that materials that were sterilized could be left inside a patient’s body. Using sterilized silver wire, he treated orthopedic injuries. Lister also adopted the usage of sterilized catgut for internal sutures, a novel concept at the time.

Joseph Lister was given great recognition for his many contributions to modern surgery. It was due to his work that the surgical mortality rate was reduced by 15 percent by 1860. After being appointed as Queen Victoria’s personal surgeon for many years, he was knighted as Sir Joseph Lister in 1883. He was made the Privy Councilor and was given the Order of Merit in 1902. He was also the founding member of the British Institute of Preventive Medicine.

His contributions to the field of modern surgery and infection prevention are invaluable.

Bibliography

Lister J. On the antiseptic principle in the practice of surgery. Lancet. 1867;90(2299):353–356.

Lister J. On the effects of the antiseptic system for the treatment upon the salubrity of a surgical hospital. Lancet. 95(2418):2-4.