Surgery changed in 1846 when Henry Jacob Bigelow published a description of ether anesthesia used by William Morton.2 Anesthesia allowed more complex and more invasive surgical procedures to be performed. However, infections remained a significant hazard in surgery. Mortality due to sepsis in abdominal or trauma surgery could exceed 50%.2 In 1867, Joseph Lister introduced the use of carbolic acid to control infections. The carbolic acid mist was spread to the operation site and instruments were washed with it. This reduced the death rate from 46% to 15% in Lister’s patients.4 In 1889-90, surgical gloves made of rubber were introduced by William Halsted and in 1894 Lister started to sterilize such gloves.5 Rapid development in the field of surgery started around the turn of the 20th century.
Surgery has an important role as a public health strategy in at least four areas:6
- in the prevention of death and chronic disability in injured patients,
- in the timely surgical intervention in obstructed labor and in obstetrics,
- in the provision of competent surgery to treat a wide range of emergency abdominal and non-abdominal conditions,
- in the surgical care of several elective conditions that have a significant effect on the quality of life (including hernias, joint prosthesis, …).
Surgical site infections (SSIs) are nosocomial infections that may be associated with all types of surgery. Despite the prevention efforts and progress made, this complication remains relatively common and still has a considerable impact on patients and public health.7 According to the European Centre for Disease Prevention and Control (ECDC), SSIs account for 19.6% of healthcare-associated infections, falling between pneumonia and gastrointestinal infections.3