American journal of surgery
-
Biography Historical Article
A critical study of Lister's work on antiseptic surgery.
The work of Pasteur on alcoholic and lactic acid fermentation demonstrated that minute organisms (germs) caused these fermentative changes. Lister applied these basic findings in the introduction of his antiseptic system. Its principles were based on the destruction of germs by antiseptics (carbolic acid) to prevent their entering the wound or spreading after surgery. ⋯ The believers of the germ theory defended Lister's theories whereas the nonbelievers of the germ theory created an atmosphere of resistance to Listerism. The work of Koch in 1878 on the etiology of traumatic infective diseases contributed greatly to the acceptance of Lister's antiseptic principles. By the mid 1880s there was a rapid increase in the use of antiseptic technics, soon followed by the introduction of aseptic methods and rapid progress in surgery.
-
Aspiration has been suggested as a source of pulmonary complications seen in patients with tracheal intubation. A previous study demonstrated that the high incidence of aspiration in patients with tracheostomies can be decreased by modification of the tracheostomy tube cuff design. In the present protocol, 100 patients with endotracheal tubes in place were studied to document the incidence of aspiration and to attempt to decrease the incidence by modification of cuff design. ⋯ In 17 patients with modified standard cuffed tubes, the incidence of aspiration was decreased to 29% (5 patients). Aspiration was further decreased to 20% (7 patients) in the 35 patients with high volume, low pressure cuffed tubes. These results demonstrate that the incidence of aspiration in patients with endotracheal tubes can be decreased by modification of endotracheal tube cuff design.