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-18th to the early 20th 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-18th 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.).