KNOWLEDGE The history of hand disinfection 175 years of development 1847: Semmelweis invents chlorinated lime for hand disinfection In the mid-19th century, due to poor hygienic conditions, around half of all patients died after surgery from so-called wound fever (sepsis) [3]. Semmelweis found that mothers died after childbirth particularly often if they were delivered by doctors who had previously performed autopsies. He drew the right conclusions and introduced hand washing with chlorinated lime in 1847. This rapidly reduced maternal mortality from up to 12% (1842) to around 1% (1848) [1]. However, it took several years for his findings to be implemented [1,3]. 1867: Lister introduces surgical antisepsis In the second half of the 19th century, the discoveries of several doctors built on each other to advance hygiene. While Robert Koch in Germany identified the causative agent of tuberculosis [4], Louis Pasteur in France discovered that heating kills micro-organisms and can make food last longer [4,5]. Meanwhile, in Scotland, Sir Joseph Lister concluded from Pasteur‘s findings that bacteria could also be responsible for poor wound healing after surgery [5]. He developed a phenol-based antiseptic that was used to clean fingers and instruments and soak wound dressings, drastically reducing mortality [4-6]. Hygiene in healthcare facilities was neglected until the first half of the 19th century, resulting in many preventable deaths. The Hungarian doctor Ignaz Semmelweis was the first to establish a link between doctors‘ hands and puerperal fever, which killed many women in labour. Semmelweis is now regarded as the founder of hygienic hand disinfection [1]. It was not until the end of the 20th century that hand disinfection with alcoholic hand rubs was recognised as the most effective way of preventing healthcareassociated infections [2]. 1965: Sterillium® conquers the world Until the 1960s, hand disinfectants used all kinds of substances that were harmful to the skin and did not last long. To improve efficacy and tolerability, researchers at BODE Chemie, a company of the HARTMANN GROUP, worked with doctors to develop Sterillium® in 1965, the first marketable alcoholic hand disinfectant. Today, Sterillium® is synonymous with hand disinfectants and is established in more than 50 countries worldwide [7]. 6
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