Rubber gloves in orthopaedic surgery (part II): Cooke and Goodyear; Halsted and Caroline's gloves of love; from cotton to rubber after Perthes' experiments; double glove technique with Urist.

PURPOSE: This study determines the timeline for surgeons adopting rubber gloves and the double glove technique in the operating room for orthopaedic surgery. MATERIAL AND METHODS: Using the vague historical terms of discovery, acceptance, commonplace, and consistency, we analyzed the influence of the different actors in each period. RESULTS: Cotton or silk was used for early gloves; they were permeable, sometimes coated with paraffin. Uses of rubber date to the 1600 s when the Mesoamericans used rubber to make shoes. After the discovery of rubber in 1735 by the French scientist Charles de la Condamine in Peru, the rubber glove was imagined in 1834 and done for the first time by R. F. Cooke. The acceptance of rubber gloves arrived when the Goodyear-Rubber Society began to manufacture rubber gloves. Halsted, at Johns Hopkins Hospital, negotiated in 1889 with the Goodyear Rubber Company to produce thin rubber gloves to protect his nurse's hands from the dermatologic effects of the carbolic acid used to sterilize instruments. Commonplace to protect patients from bacteria of hand surgeons necessitated several decades. Dr. Joseph Bloodgood (Halsted's senior resident) remarked that gloving the surgeon with rubber gloves reduced the infection rate. Still, surgeons were reluctant to wear gloves that impaired the sense of touch. Laboratory experiments performed by G. Perthes on cotton and rubber gloves were necessary to generalize rubber gloves for practice in orthopaedic surgery. Consistency of the double-glove technique arrived during World War II when M. Urist proposed the double protection against bites from bone or bullet fragments while exploring war wounds. Only in 1965, when The Ansell Rubber Company utilized gamma irradiation as a low-cost method of sterilizing the gloves they produced, did disposable gloves become sterile. CONCLUSION: This article helps to understand the detailed discussions before surgical gloves' modern operating equipment.

The strange history of surgical gloves in orthopaedic surgery (part I): from no gloves and no hand washing to the introduction of cotton gloves in orthopaedic surgery.

PURPOSE: The goal was to evaluate the advent of surgical gloves during the eighteenth century, nineteenth century, and the beginning of the twentieth century. MATERIAL AND METHODS: We used first drawings and paintings, then historical photographs identified in books after 1830 (date of discovery of the photography) or in medical reports of surgery and anesthesiologists. The pictures determined the presence or absence of gloves in the period corresponding to the changing understanding of aseptic and antiseptic techniques proposed by Lister and Pasteur. RESULTS: There was an evolution of the material of gloves, but surgeons throughout time remained significantly opposed to gloves for a long period. Concerning materials, the caecum of a sheep, cotton, silk, leather, and crude rubber were used before the introduction of latex by Goodyear. For surgeons, gloves were introduced initially to protect theatre staff's and surgeon hands from infection and not to protect the patient. Many surgeons contributed to the evolution of surgical gloves, and the use of gloves was an evolutionary process rather than a discovery. The probability that a surgeon had gloves on photographs was 0% in 1860-1870 (period of Lister and Pasteur), 5% in 1890, 28% in 1900, 42% in 1910, 48% in 1920, 58% in 1930, and 75% during the World Word II and reached 100% only in 1950. CONCLUSION: While some reports suggest that by 1920, the use of gloves in surgery became routine practice, in reality, around 30% of trauma surgeons were not wearing gloves until 1939.

Hakim Mohammad: A Persian Military Surgeon in Safavid Era (1501-1736 CE).

BACKGROUND: Wars and injuries have accompanied mankind throughout history. Physicians and surgeons from various civilizations made difficult attempts to manage wounds and injuries. Among various civilizations, the Persian Empires had great armies which were well equipped. One of the most important organizations in Persian troops was the military surgery. METHODS: This study presents a brief biography of Hakim Mohammad (a military surgeon in Safavid era) and introduces his book, Dhakhira-yi-Kamilah. RESULTS AND DISCUSSION: Safavid kings (1501-1736 CE) with unifying all of Persian regions and provinces reconstructed the Persian Empire. Great scholars and physicians were raised in this era. It seems that Persian physicians and surgeons were well trained in Safavid era and many of them were even employed by other countries like Ottoman Empire and India. Hakim Mohammad as a military surgeon was one of such physicians who served in Ottoman Empire for some time. He gathered his surgical experiences and others in the book of Dhakhira-yi-Kamilah. This book was written in Persian. He has mainly written about the management of wounds and practical techniques. Later, he came back to his homeland and dedicated his book to the king of Persia.

Negotiating technologies in surgery: the controversy about surgical gloves in the 1890s.

This article examines the controversial discussions about surgical gloves in the German-language countries in the 1890s. Analyzing the controversy as a contradiction between two important strategies of modern surgery, manual control and aseptic control, it looks at the various ways surgeons dealt with the conflict. Most important, they tried to resolve the problem by designing gloves that reconciled the two conflicting control strategies. This perspective helps to better understand the lengthy process of negotiation and the detailed discussions in the decades before surgical gloves became a standard element of modern operating equipment.

[The gloves of love].

INTRODUCTION: Thin rubber gloves were used for the first time in the history of medicine at the end of 1889. On the occasion of the 120th anniversary of that event at the end of 2009, the great importance of that discovery for the development of surgery in general should be emphasized once again. The surgical gloves were invented and introduced by a famous American surgeon Dr. William Halsted from Johs Hopkins Hospital in Baltimore (USA). DR. WILLIAM HALSTED AND MISS CAROLINE HAMPTON: This significant innovation actually occured thanks to the romance between Dr. W. Halsted and his scrub nurse Miss Caroline Hampton, later his wife, Mrs C. Halsted. According to the antiseptic practice of that hospital the hands of the operating personnel had to be desinfected in mercuric chloride which damaged the skin of nurse Caroline who developed a bad case of dermatitis, and because of that she considered abandoning the hospital. This prompted Dr. Halsted to contract Goodyear Rubber Company to produce thin rubber gloves to protect Caroline's hands and to keep her in his vicinity. They proved to be very satisfactory and soon Dr. Halsted's assistants too began to wear sterilized rubber gloves routinely. COMMENTARY AND CONCLUSION: Although it was not until later that the importance of rubber gloves in preventing infection was realized these "gloves of love" soon entered into general surgical practice and proved to be of the greatest importance for the development of asepsis and aseptic surgical work.

Surgical gloves.

Surgeons and obstetricians, over the centuries, were only too aware that accidental open injuries during their work, especially in a septic case, could lead to an infected wound, a fulminating illness and often death. Even before the bacterial nature of infection had been established in the mid 19th century, it was still obvious that this dangerous and often fatal condition was caused by the transfer of some poisonous material or 'miasma' from the patient to his surgeon. As long ago as 1758, an obstetrician named Walbaum protected his hands by covering them with sheep's caecum. Others used gloves of cotton, silk and leather. After Charles Goodyear developed the vulcanisation process to stabilise rubber in 1844, this became the material of choice for these rather crude protective gloves.

A surgical review of the priority claims attributed to Abraham Groves (1847-1935).

BACKGROUND: The practice of surgery had changed little over millennia when Abraham Groves and William Osler attended medical school together in Toronto, Ontario. The invention of anesthesia sparked such rapid development that by the time of Groves' and Osler's deaths, surgical practice resembled the current model. Several priority claims have been attributed to Groves' life in surgery, including aseptic surgery (1874), suprapubic lithotomy (1878), appendectomy (1883), surgical gloves (1885) and cancer radiotherapy (1903). These claims arise from an autobiography written by Groves at the age of 87 years in 1934. METHODS: The purpose of this paper is to assess these priority claims from a modern surgical perspective. We did a systematic search of contemporary (1873-1934) and modern journals for articles by or about Groves. We searched relevant archives and museums. We reviewed the 1934 autobiography, notes held by descendants, reminiscences by contemporaries and collateral information. We assessed the information not only for priority but also for the development of organized surgical thought. RESULTS: Groves published frequently throughout his career; thus far we have located 36 papers, almost all of which were published in Canadian journals. He spoke regularly at regional meetings in Ontario. Many medical students apprenticed with him (including his brother, son and grandson), he established a hospital and he founded a school of nursing. His contemporaries published complimentary reminiscences, but no correspondence with his classmate, William Osler, is known. Groves' priority claims for aseptic surgery, suprapubic lithotomy and radiotherapy are supported by contemporary publications. Groves independently developed an organized surgical system that remains valid today. Priority claims for appendectomy and the use of surgical gloves are entirely consistent with that system. CONCLUSION: Although Groves' impact was reduced by his location and the limited circulation of the journals in which he wrote, he demonstrated a systematic understanding of modern surgery well ahead of his contemporaries.

[William Stewart Halsted--110 years of the use of surgical gloves].

INTRODUCTION: William Stewart Halsted was born in New York in 1852 and is generally regarded as the most innovative and influential surgeon the United States has produced. CONTRIBUTIONS TO SURGERY: The number and magnitude of Halsted's contributions to surgery are staggering. They range from the development of a surgical procedure for breast cancer, to the introduction of rubber gloves in the operating room. They include some of the earliest operations on the biliary tract, introduction of the plate and buried screw technique in the management of long bone fractures, and some of the earliest and most innovative approaches to the treatment of aneurysms of the great vessels. Halsted also developed the submucosal intestinal suture, which allowed the development of the broad field of alimentary tract surgery. He made important contributions in the area of parathyroid and thyroid surgery, and his monograph on thyroid goiter became a classic. Halsted developed an operation for inguinal hernia repair in an era in which they virtually were incurable. One of his most notable contributions was the introduction of local and regional anesthesia. He was the first surgeon in the U.S. who promulgated the philosophy of "safe" surgery. He advocated the gentle handling of tissues during surgery, careful hemostasis, avoidance of dead space, and a meticulous surgical technique at a time when speed, lack of attention to hemostasis and rough handling of tissues were the rule. Perhaps his most important contribution to surgery, however, was the introduction of a new system of training young surgeons. He died in 1922.