Concept

Asepsis

Summary
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is derived from the older antiseptic techniques, a shift initiated by different individuals in the 19th century who introduced practices such as the sterilizing of surgical tools and the wearing of surgical gloves during operations. The goal of asepsis is to eliminate infection, not to achieve sterility. Ideally, a surgical field is sterile, meaning it is free of all biological contaminants (e.g. fungi, bacteria, viruses), not just those that can cause disease, putrefaction, or fermentation. Even in an aseptic state, a condition of sterile inflammation may develop. The term often refers to those practices used to promote or induce asepsis in an operative field of surgery or medicine to prevent infection. The modern concept of asepsis evolved in the 19th century through multiple individuals. Ignaz Semmelweis showed that hand washing prior to delivery reduced puerperal fever. Despite this, many hospitals continued to practice surgery in unsanitary conditions, with some surgeons taking pride in their bloodstained operating gowns. It was not until after reading of the findings by Louis Pasteur that Joseph Lister introduced the use of carbolic acid as an antiseptic, and in doing so, reduced surgical infection rates. Lawson Tait shifted the movement then from antisepsis to asepsis, instilling practices such as a strict no-talking policy within his operating room and drastically limiting the number of people to come in contact with a patient's wound. Ernst von Bergmann also introduced the autoclave, a device used for the practice of the sterilization of surgical instruments. But, everything from operating room uniforms to gloves was pioneered by William Halsted. Preceding modern-day scrubs attire, Halsted implemented a no street clothes policy in his operating room, opting to wear a completely white, sterile uniform consisting of a duck suit, tennis shoes, and skullcap.
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