Development of Aseptic Surgical Technique

Aseptic technique is the practice of excluding disease-causing microorganisms from a surgical field entirely, developed as a stricter successor to antisepsis, which killed germs already present on a wound rather than preventing their presence in the first place. Italian surgeon Giuseppe Ruggi began the shift away from purely antiseptic methods in the 1870s, publishing his findings in 1879; German surgeon Gustav Neuber introduced sterile surgical gowns and caps in 1883; and German surgeon Ernst von Bergmann introduced steam sterilization of surgical instruments with the autoclave in 1891. American surgeon William Halsted further advanced the practice at Johns Hopkins Hospital in the 1890s by introducing thin rubber surgical gloves and a fully sterile operating uniform and hand-washing routine. Together these innovations replaced chemical disinfection of an already-contaminated field with a comprehensive system of sterilizing instruments, gowns, gloves and the operating environment before surgery began, sharply reducing surgical site infection and establishing the sterile-field standard that remains the basis of operating room practice today.