OPERATING ROOM TECHNIQUE

HISTORICAL BACKGROUND

Genesis 2:21 – God was the first to perform a surgical procedure

“Surgery is as old as the human being” according to Linda Groah
- As found on skulls
‘Edwin Smith Papyrus – earliest scientific document dedicated to record history of surgery about 300 BC in Egypt
- Contains accurate observation on anatomy, physiology and pathology
On The Surgery- a book authored by Hippocrates
( The Father of Medicine)
- he wrote 70 books on medicine and surgery
- first to coin some items related to surgery, instrumentation, and recognized the value of assistant during
surgery

• Ancient Egyptian papyri chronicle the progress of medicine & surgery upto 1600 BC • Babylonian Law - Code
of Hammurabi
• Ancient Persians : 3 infidels to be pronounced as competent to practice surgery
• Cladius Galen (130-200) "Father of experimental Physiology" gave contributions to medical discipline but
surgery remained a primitive practice and lacked a scientific base for the next 1200 years
• Until 1540, surgeons and barbers of the 13th & 14th century England belonged to the same professional guild
• 16th,17th & 18th century many discoveries were made because of Ambroise Pare’ – member of the Corporation
of Barbers
• The combined group of surgeons & barbers were dissolved in 1745 and by 1800 the Royal College of
Surgeons of London was chartered
• 19th century operating room education become a necessary element for the success of the surgical team
• 2 different types of education:(1)surgeons & their assistants ;(2) surgical nurses; recognized the complexity of
surgical procedures were dynamic
• discovery (1842-1847) of anaesthesia, that barrier to progress in actual operations was removed
• Hospital gangrene, septicaemia, tetanus, & pyaemia remained as problems until the French chemist Louis
Pasteur evolved his germ theory & discovered that fermentation is caused by micro-organisms in surgery
• British surgeon Sir Joseph Lister applied the discoveries of Pasteur to surgery & formulated his theory
concerning sepsis & antisepsis, another major obstacle was removed.
• The era of modern surgery probably began with the notable event of the performance (1809) of ovariotomy
(removal of the ovaries) in the treatment of ovarian disease by the American surgeon Ephraim McDowell of
Kentucky
• 1873 – nursing school opened in US patterned after Florence Nightingale’s school at St. Thomas Hospital in
London
• 1875 – Bellevue Report listed lectures on “surgical Instruments and Preparation for Operation, “bandaging”
and “homeostasis”
• 1889- John Hopkins University was established to train doctors and nurses. Operating Room Nursing was
identified as an area of specialization
• 1891- students were given responsobility in cleaning and sterilizing instruments for Saturday operations
• 1896- students could assist with Saturday operations
• 1901- Marta Luce believe that OR Nurse know the principles of asepsis, careful attention to details, and much
forethought in the operation of supplies
• 1900- surgeons wears scrub suits, performs surgical scrubbing, wearing of sterile gloves
• 1905- instrument nurse to wear rubber gloves and wear a sterile gown
• 1907- use of head coverings was advocated
* Role of circulator and scrub nurse emerge.
Scrub nurse must be the senior nurse
• 1910 – nursing authorities agreed that circulating nurse must be the senior nurse
• 1914 - use of surgical mask by the sterile team
• 1920-1940- students spent part of their training in the OR and could effectively function.
• 1927- the American Journal of Nursing published an article entitled “The Operating Supervisor and Her
Qualifications”
• 1919- “The Operating Room Technique” was added in the standard curriculum
• 1941-1945-orderlies &OR tech. was created (World War II)
• 1969-objective of clinical practice was identified to provide standard of excellence in the care of the patient
before, during and after surgical intervention”
• 1980-1990- hospital administrators discovered that surgery provided care of equal quality is cheaper
Perioperative Nursing keeps on evolving to address the need of the time
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