Awais Shuja
Faisalabad, Pakistan
History
GLOVES AND SURGERY
S urgical gloves have been used in
operating rooms for over 100
years. The use of surgical gloves is
universal. The surgical gloves have
evolved over last two centuries to
the present day situation. The story
of surgical gloves is of intrigue and
romance
The idea of surgical gloves
originated from maternity wards in
late 18th century. The first recorded
use of gloves was in 1758 by J.J.
Walbaum a German physician.
These were used for vaginal
examinations and deliveries.
Further progress was made half a
century latter when in 1834
Semmelwis in his article “ Highly
Important observations on the
etiology of puerperal fever
epidemic in lying in hospitals” had
presented forceful evidence that
contagion could be spread by
health care workers, even while they
were attending to standard
operating procedure in mortuary
and delivery suite.
New Jersey Physician, Richard F
Cooke in 1834 suggested that “ a
pair of India rubber gloves would be
perfectly impenetrable to the most
malignant virus”. This became the
basis of gloves used for protection
of hands during postmortem
examination These were made of
99 April to June, 2010
IR-043
Gutta percha and patented in 1848
through both US and British patent
offices.
Around the same period across the
world in Europe heavy rubber
gloves were in use. In 1838 in
Middlesex Hospital in London. Sir
Thomas Watson used rubber gloves
to protect mother during deliveries.
On same continent in Germany
heavy rubber gloves were being
used for autopsies and eventually
lead to introduction of use of gloves
during surgery.
History of gloves is incomplete
without mentioning the develop-
ment of rubber which is used in
production of surgical gloves. The
origin of rubber can be traced back
th
to 16 century when natives of Haiti
played a game with a ball made
from the gum of a tree. In 1791 the
first commercial application of
rubber was initiated when an
English Manufacturer, Samuel Peal
patented a method of water
proofing cloth by treating it with a
solution of rubber in turpentine. The
rubber used in England at that time
came from India and the term
“Indian Rubber” was widely used.
The accidental discovery by
American Enterpreuner Charles
Goodyear changed the course of
history. For years Goodyear tried to
INDEPENDENT REVIEWS
make rubber that would not be
affected by the temperature. One
day Goodyear accidently spilled a
mixture of rubber and sulphur on a
hot stove. When he removed it. He
found that the rubber could be
stretched and was not gummy. He
found that in order to make a rubber
manufacture you need to add
rubber, sulphur and intense heat. In
1844 he had his discovery
patented. The process was called
vulcanization after the roman God
of fire.
In 1878 Thomas Forster an
employee of the India Rubber Works
in England obtained a patent to
make surgical gloves from
vulcanized rubber.
The discovery in winter of 1889 and
1890 changed surgical practice for
ever. The great surgeon of all times
William Halstead made another
invaluable contribution to surgical
technique. Dr Halstead’s operating
room nurse Miss Caroline Hampton
developed an eczema of the
delicate skin on her hands from
repeated plunging into carbolic
acid and bichloride of mercury.
Halstead fancied her so to protect
her hands he tried painting her
hands with collodion but this failed
because the collodion covering
would split when the fingers
contracted. William Welch was
employing in his autopsy work a
pair of heavy rubber gloves from
Germany. When Halstead saw
them, he immediately thought of
April to June, 2010 INDEPENDENT
using gloves for Miss Hampton and
the Goodyear rubber company to
manufacture some. The original
gloves had long sleeves that came
up to the elbow, and Miss Hampton
found them an immediate success.
When Halstead offered her the thin
rubber gloves “ laughing impishly”
an that Caroline Hampton had kind
of prophetic fit , exclaiming.
“They are not for me alone. This is a
true salvation for all the surgeons
and nurses of the world”.
A colleague of W. Halstead put it
“Venus came to aid of Aesculapius”
This episode of history ended in
marriage of Halstead to Hampton
and contributed enormously to
surgical practice in form of
introduction of surgical gloves.
In this piece of history the role of
Joseph Bloodgood cannot be over
looked. One of the disciples of
William Halstead at John Hopkins
Hospital, J Blood good reported the
“results criteria” in showing the
patient benefit sustained by the
practice of gloving entire surgical
team, to which he attributed a
dramatic reduction in infection rate
From 1893 after Bloodgood’s
reported surgical gloves for entire
surgical team became an universal
practice. A year later in 1894 a
Gynaecology resident Hunter Robb
was the first person to publish a
book. “Aseptic surgical technique”
recommending operator wear
gloves.
REVIEWS 100
 Like every change, this development
also faced resistance from the
surgeons. The rear guard took up
the fight. Rather ingenious
experiments were undertaken to
prove that gloves were more a
hindrance than a help in surgical
care. Three blind girls reading
Braille showed that rubber gloves
impaired the sense of touch. Over
time, the resistance was short lived
when the minimal impairment to
surgical touch was compared with
the considerable greater advantage
in decreased surgical infection rate.
Especially for those surgeons
brought up under a new era of
gloved dexterity, it become second
nature and no loss was
experienced.
From late nineteenth century the
surgical gloves have been adopted
universally. In Britain, surgical
gloves were first used by Lynn
Thomas a Cardiff surgeon in 1905.
Gloves evolved in the following
decades; the heavy, tough, reusable
rubber coverings had by the 1930’s
101 April to June, 2010
become a more flexible better
fitting, brown milled” item made
from a solution of rubber cement.
Single use latex gloves debuted in
1958 and were widely adopted by
late 1960’s and early 1970’s. Their
acceptance was doubt hastened in
1970 when hospitals become
subject to minimum wage laws, a
more that made the maintenance of
reusable mits – a laborious process
carried out by nurses – too
expensive to perpetuate.
Initially the gloves were intended to
protect hands of operator. The
purpose has expanded to protect
patient as well as staff. Surgical
gloves provide a barriers to
transmission of infection. Modern
innovations have been developed
as use of gloves with perforation
indicator systems, and gloves with
liners. The dexterity has increased
with improved quality of gloves.
In future we hope to see further
developments in objectives and
quality of surgical gloves.
INDEPENDENT REVIEWS
HISTORICAL TIME LINE OF THE DEVELOPMENT OF SURGICAL GLOVESw

1758 Obstetric “glove” made from caecum

J J Walbaum of a sheep

1834 Richard F. Cooke “A pair of India rubber should be

Hoboke, New Jersey perfectly impenetrable to the most
malignant virus”.

1835 Charles Goodyear Initiated research that stumbled into

vulcanization of rubber.

1838 Sir Thomas Watson. Rubber gloves to protect mother

during deliveries; “one such glove
sacrificed to the safety of the mother”
= disposable.

1848 W.Acton Gutta-percha gloves to protect hands

during post-mortem – British and US
patent Offices.

1878 T.Forster “Manufacturer of Gloves for Surgical

operations”

1889 W.S. halsted The “Caroline Hamptom Story” and

the Goodyear Company.

1893 J.G. Bloodgood Gloved all members of surgical team.

1894 H.H. Robb. Published book Asrptic surgical

Technique recom-mending operator
wear gloves.

1897 Zoeg von Manteuffel Published report on rubber gloved to

protect surgeons’ hands
from antiseptics and the infected
materialof septic drainage.

1897-Mikulicz Cotton gloves for the all participants

but operator.
Leather gloves fot operator.

April to June, 2010 INDEPENDENT REVIEWS 102

 References
1. Spirling LI, Daniels IR. William Stewart
Halsted--surgeon extraordinaire: a
story of drugs, gloves and romance'R
Soc Promot Health. 2002 Jun;
122(2):122-4
2. Germain MA The advent of surgical
glovesAnn Chir. 2003 Sep;128 (7):
475-80. Tewari.m . 'The professor',
william steward: A legend.indian jsurg
2004;66:232-3
103 April to June, 2010
3. Zdravković D, Bilanović D, Dikić S,
Zdravković M, Milinić NMed Pregl.
2007 Jul-Aug;60(7-8):405-
8.William Stewart Halsted--110 years
of the use of surgical gloves. 07Jul-
Aug;60(7-8):405-8.
4. Geelhoed GW. The pre-Halstedian
and post-Halstedian history of the
surgical rubber glove. Surg Gynecol
Obstet. 1988 Oct;167(4):350-6.
INDEPENDENT REVIEWS