We focus on
Surgery

Access to surgical care saves lives and prevents disability.

WHO (World Health Organization) reported almost 30 million surgeries performed in European countries (based on last data available).1

For more than a century, surgery has been an essential component of public health. As longevity increases worldwide, its role is still increasing. Surgery has evolved in numerous subspecialties and currently, there are more than 2500 different surgical procedures.2

30 million

surgeries per year

in Europe1

More than

2,500

different surgical procedures2

Surgical Site Infections
account for

19.6%

of healthcare-associated infections3

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

REFERENCES
  1. WHO Total number of inpatient surgical procedures per year https://gateway.euro.who.int/en/indicators/hfa_539-6031-total-number-of-inpatient-surgical-procedures-per-year/visualizations/#id=20118&t ab=table
  2. Gawande A., Two Hundred Years of Surgery. New England Journal of Medicine 2012;366: 1716-1723.
  3. ECDE European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; 2013. doi 10.2900/86011.
  4. Lister J. On the effects of the antiseptic system of treatment upon the salubrity of a surgical hospital. Lancet 1880; 95:40-42.
  5. Barton M. The History of Surgical Gloves 2018 Available from: https://www.pastmedicalhistory.co.uk/the-history-of-surgical-gloves/ [Accessed 25th January 2021]
  6. WHO Surgery chapter 67 https://www.who.int/surgery/SurgeryDebasworldbank.pdf?ua=1
  7. WHO Global guidelines for the prevention of surgical site infection; 2018 1-186.