History of Wound Care - 19th Century

19th Century

The first advances in wound care in this era began with the work of Ignaz Philipp Semmelweis, a Hungarian obstetrician who discovered how hand washing and cleanliness in general in medical procedures prevents maternal deaths. Semmelweis's work was furthered by an English surgeon, Joseph Lister, who in 1860s began treating his surgical gauze with carbolic acid, known today as phenol, and subsequently dropped his surgical team's mortality rate by 45%. Building on the success of Lister's pretreated surgical gauze, Robert Wood Johnson I, co-founder of Johnson & Johnson, began in 1870s producing gauze and wound dressings treated with iodine. These innovations in wound-site dressings marked the first major steps forward in the field since the advances of the Egyptians and Greeks centuries earlier. In 1886, Ernst von Bergmann introduced heat sterilization of surgical instruments, which marked the beginning of aseptic surgery and significantly reduced the frequency of infections. In 1898, Paul Leopold Friedrich introduced wound excision and experimentally showed that excision of open wounds substantially reduced the risk of infection. The next advances would arise from the development of polymer synthetics for wound dressings and the "rediscovery" of moist wound-site care protocols in the mid 20th century.