History of surgical infections

Lectures details• History and background of infection in Surgery • Significance of Hand hygiene / guidelines• Surgical site infection / guidelines• Prophylaxis and use of Antibiotics• Common Surgical infections and their management -1• Common Surgical Infections and their management – 2

PHYSIOLOGY AND PRESENTATION• Background

• Egyptian Mummification• The Hippocratic teachings – Wine and vinegar

PHYSIOLOGY AND PRESENTATION• Background

• Egyptian Mummification• The Hippocratic teachings – Wine and vinegar

• Galen

Caliph Harun al- RasheedAr-Rashid (1109–1138 AD).

PHYSIOLOGY AND PRESENTATION• Background

• Egyptian Mummification- EGYPT• The Hippocratic teachings – Wine and vinegar- GREEK• Galen- ROME• Ignaz Semmelweis - AUSTRIA• Robert Koch – Anthrax / typhoid/ Tuberculosis

Ignaz Semmelweis - AUSTRIA

• deadly malady known as “childbed” or puerperal (from the Latin words for child and parent) fever.

• In the mid-19th century, about five women in 1,000 died in deliveries performed by midwives or at home.

• The maternal death rate was often 10 to 20 times greater.

http://www.pbs.org/newshour/updates/ignaz-semmelweis-doctor-prescribed-hand-washing/

Childbed fever• “a miserable end it was: raging fevers, putrid pus emanating from the

birth canal, painful abscesses in the abdomen and chest, and an irreversible descent into an absolute hell of sepsis and death — all within 24 hours of the baby’s birth.”

Cause – Curriculum - Anatomy• Medical students and their professors at the elite teaching hospitals

of this era typically began their day performing barehanded autopsies

Cause – Curriculum - Anatomy• Medical students and their professors at the elite teaching hospitals

of this era typically began their day performing barehanded autopsies• Most commonly women dying within the past 24 hours

Cause – Curriculum - Anatomy• Medical students and their professors at the elite teaching hospitals

of this era typically began their day performing barehanded autopsies• Most commonly women dying within the past 24 hours• Coming to maternity for deliveries

“ Morbid Poison”

Published in 1861

PHYSIOLOGY AND PRESENTATION• Background

• Egyptian Mummification• The Hippocratic teachings – Wine and vinegar• Galen• Ignaz Semmelweis• Robert Koch’s postulate

Louis PasteurFrance

Joseph ListerThe broken bones (1866)

Surgical Site Infections • SSIs occur within the first 30 days after the operation if no implant is

placed or within 1 year if an implant remains