The strange history of surgical gloves in orthopaedic surgery (part I): from no gloves and no hand washing to the introduction of cotton gloves in orthopaedic surgery.

PURPOSE: The goal was to evaluate the advent of surgical gloves during the eighteenth century, nineteenth century, and the beginning of the twentieth century.

MATERIAL AND METHODS: We used first drawings and paintings, then historical photographs identified in books after 1830 (date of discovery of the photography) or in medical reports of surgery and anesthesiologists. The pictures determined the presence or absence of gloves in the period corresponding to the changing understanding of aseptic and antiseptic techniques proposed by Lister and Pasteur.

RESULTS: There was an evolution of the material of gloves, but surgeons throughout time remained significantly opposed to gloves for a long period. Concerning materials, the caecum of a sheep, cotton, silk, leather, and crude rubber were used before the introduction of latex by Goodyear. For surgeons, gloves were introduced initially to protect theatre staff's and surgeon hands from infection and not to protect the patient. Many surgeons contributed to the evolution of surgical gloves, and the use of gloves was an evolutionary process rather than a discovery. The probability that a surgeon had gloves on photographs was 0% in 1860-1870 (period of Lister and Pasteur), 5% in 1890, 28% in 1900, 42% in 1910, 48% in 1920, 58% in 1930, and 75% during the World Word II and reached 100% only in 1950.

CONCLUSION: While some reports suggest that by 1920, the use of gloves in surgery became routine practice, in reality, around 30% of trauma surgeons were not wearing gloves until 1939.