Brief Report The American Surgeon 2020, Vol. 0(0) 1–2 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0003134820984876 journals.sagepub.com/home/asu The Significance of Antiseptic Techniques During the COVID-19 Pandemic: Joseph Lister’s Historical Contribution to Surgery Youssef Shaban, DO 1 , Mark McKenney, MD, MBA, FACS 1 , and Adel Elkbuli, MD, MPH 1 With the current state of the world dealing with a viral pandemic, it is important to remember and honor the surgeon, Dr Joseph Lister, who provided us the basic principles of antisepsis, sterilization, and disinfection. Beginning in Wuhan, China, in December 2019, the novel coronavirus, also known as SARS- CoV-2, has spread worldwide and become a global crisis. The virus can lead to a clinical syndrome, COVID-19, that en- compasses mild to moderate respiratory symptoms, fe- vers, acute respiratory distress syndrome, and even death. 1 At the time of writing this (April 5th, 2020), there are over 1.2 million confirmed cases worldwide, with over 300 000 cases in the United States with nearly 5000 deaths and over 66 000 deaths worldwide. 1 This disease was offi- cially classified as a pandemic by the World Health Or- ganization on March 11, 2020, and the Unites States declared a state of emergency on March 13, 2020. 1 In the late 1800s, when the death rate from post- operative infection was considered outrageous, there were movements to abolish surgery. 2,3 While surgeons tried to prevent wound infections, there was no consensus to the origin or etiology. In the 1850s, infected wounds were so prevalent that many doctors considered “laudable pus” a key step in the pathophysiology of normal wound healing. Leading notions on wound infections came from the theory of miasma or “bad air” and spontaneous generation. A stench from the operating room was commonplace and referred to as, “good old hospital stink.” 2 Dr Joseph Lister applied Louis Pasteur’ s germ theory of disease and championed the first antiseptic extensively applied in surgery. Lister’ s methods transformed surgery into a modern science, and with the prevention of post- operative infection, surgeons were able to delve further into the living body and save countless lives. 2 Born in Essex, England, in 1827, Lister was raised by a Quaker family. His father, Joseph Jackson Lister, a fellow of the Royal Society for his critical role in the early development of the achromatic lens instructed him in natural history and the use of the microscope which had a significant impact on Lister’ s career. In 1852, Lister graduated University College London with a bachelor of medicine with honors and subsequently became a fellow of the Royal College of Surgeons. On the advice of his mentor, Professor Sharpey, Lister traveled to Scotland to train under the renowned surgeon Dr James Syme at the University of Edinburgh. He was eventually promoted to house surgeon in 1854 and married Syme’ s oldest daughter. However, when he returned to the hospital from his honeymoon, he continued to face the same devastating issues of his time; patients were dying from gangrene, erysipelas, and septicemia with an unbearable surgical infection mortality rate. 2,3 Unsatisfied with accepted theories on inflammation and infection, Lister continued his scientific research under the microscope, investigating inflammation and how blood vessels reacted under different circumstances. He experimented on vivisected frogs to elucidate the role that the central nervous system played in inflam- mation which he would present at the Royal College of Surgeons in Edinburgh. He published 15 articles based on his original findings on the pathophysiology of inflammation. 2 Lister eventually was promoted to professor of clinical surgery at the University of Glasgow; however, he became increasingly frustrated with the excessive mortality rate of 50% among his amputation patients between 1861 and 1865. In his desperation to find the etiology of in- fection he turned to this students, “… the man who is able to explain this problem will gain undying fame.” 3 Through a recommendation from his colleague, Lister became familiar with the latest research on fermentation and putrefaction, Recherches sur la putrefaction, by the 1 Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA Corresponding Author: Adel Elkbuli, MD, MPH, Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, 11750 Bird Road, Miami, FL 33175, USA. Email: Adel.Elkbuli@hcahealthcare.com