Innovative practice in the manufacture of aseptic surgical environments in the late nineteenth century

Abstract

Contemporary spaces for surgery are highly energy intensive, much of which is attributed to powerful air conditioning systems intended to force air down onto the patient, surgical staff and instruments to keep airborne pathogens from sedimenting on patients and equipment during surgery. The carbon footprint from these systems is prodigious in a service required to dramatically cut emissions. Sufficient doubts have arisen from experimental modelling and data collected in surgical theatres that pathogens are expelled efficiently to encourage broader speculation about the fundamental configuration of spaces for surgery. One prospective avenue is the investigation of the aseptic movement’s operating room designs of the late nineteenth and early twentieth centuries before the adoption of air conditioning. Historical review and testing of theatre design, as part of the Excising Infections in Surgical Environments (ExISE) project, identified a carefully designed and innovative operating room in Hamburg’s general hospital. The St. Georg’s Operationshaus (1899) is reconstructed digitally, analysed theoretically and modelled experimentally to determine modern utility as a green theatre. Results are promising but are affected by the parallel intent to introduce prodigious natural daylighting; however, the effects of this on the airflow patterns in the space could be managed by modern materials and control technologies.