PubMed · 3405270
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R B Kundsin, C W Walter. 1988-09-01. Legionella prosthetic-valve endocarditis.. https://doi.org/10.1056/nejm198809013190913
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PURPOSE: Joseph Lister introduced antiseptic surgery in 1867. American surgeons, entrenched in the old ways of 19th century medicine, failed to adopt Lister's methods. MATERIALS AND METHODS: Examples of the hubris and arrogant thinking displayed by early American surgeons are best shown by Thomas Eakins' masterpiece, The Gross Clinic, and by the death of President James Garfield. RESULTS: Samuel Gross, preeminent American surgeon in 1875 boldly revealed in The Gross Clinic, and the team of distinguished surgeons using outdated methods caring for Garfield in 1881, illustrate American surgeons' woeful disdain and disregard of sterile surgical methods. CONCLUSIONS: Public outcry over the failure of some of America's best surgeons led to widespread adoption of antiseptic surgery by the late 1880s and introduction of basic science into the medical education by the dawn of the new century.
BACKGROUND: Removal of rings is recommended before surgeons aseptically prepare for surgical procedures. OBJECTIVES: This study was undertaken to determine whether there is a difference between bacterial counts under surgical gloves of ring wearers compared with nonring wearers after proper aseptic hand preparation and 3 hours of wear. METHODS: Twenty volunteer veterinary medical students were divided into 2 groups: One group wore a smooth ring band (without projections or mounted stones) on their ring finger, and the other group did not wear a ring. A modified glove juice method was used to obtain bacterial counts (colony-forming units/mL) inside surgically gloved hands prior to a proper aseptic hand preparation and 3 hours after hand preparation and wear. Each of the pre- and postsurgical glove juice samples were inoculated onto Letheen agar plates, which were incubated aerobically under atmospheric conditions for 48 hours at 35 degrees C. Gloves were tested for perforations using a water pressure test. RESULTS: No differences, or significant change, in bacterial counts were found before or after surgery between all ring hands and nonring hands or between ring and nonring hands for ringed participants. No differences in bacterial counts were found within perforated versus nonperforated gloves. CONCLUSION: There is no compelling evidence to suggest that surgeons wearing rings possess higher bacterial counts under their gloves during surgery.
Critical care medicine was born from the selective pressures of human disease, and with the perseverance and foresight of a select few pioneers, has become an independent field of medicine. This introduction travels back in time to evaluate those visionaries and their landmark contributions. Advancements in caring for the critically ill and organ failure occurred during the wars of the twentieth century. Landmark advances in the management of respiratory paralysis occurred in the polio epidemic of the 1940s. It was during this era that the world's first ICU was developed. Contemporary critical care differs considerably from that which marked its birth. Much of the technology we currently employ is assumed: invasive hemodynamic monitoring, mechanical ventilation, antisepsis, and antibiotics.