Estonian Scientific Feats: Rubber gloves for surgeons

VINCENT TEETSOV

Rubber gloves form an integral part of modern day medicine. They protect patients from infections. They protect surgeons, anaesthesiologists, nurses, and surgical technicians from bodily fluids. They provide a layer of sterility that cannot be achieved by just washing one’s hands; and thus, they prevent the contamination of medical instruments used during surgeries, the delivery of babies, or during routine checkups.

We probably don’t think twice when a nurse or doctor pulls a rubber glove on. In fact, we’ve come to expect it. And yet, nearly 130 years ago, these gloves were not ubiquitous. If gloves were used at all, they were more likely to be made of materials like cotton, silk, or leather.

In the book Contact Urticaria Syndrome published by the Taylor & Francis Group in 2015, it’s said that “In 1813, Adam Elias von Siebold initially suggested the use of latex gloves to reduce the risk of infections... The first pair of rubber gloves for surgical use was produced in circa 1889 by the Goodyear Rubber Company.”

These gloves were made for surgical nurse Caroline Hampton and surgeon Dr. William Stewart Halsted of Johns Hopkins Hospital in Baltimore, Maryland. It’s often noted that they introduced rubber surgical gloves to the United States. This was done not to prevent the spread of infections, but rather, as Dr. Halsted explained later in his life, to protect the hands of Caroline Hampton from disinfectants that irritated her skin.

But it was Werner Maximilian Friedrich Zoege von Manteuffel, an Estonian of Baltic German heritage, who first widely advocated, in writing, for the sterilization and use of these gloves. They were known as “boiled hands” due to the way they were placed in boiling water for sterilization.

Von Manteuffel was born on July 13th, 1857 at Määri Manor, in the village of Määri, Lääne-Viru County. He studied at the present-day University of Tartu, achieving his doctorate degree in 1886 and then becoming a professor of surgery just before the turn of the 20th century.

In 1897, von Manteuffel wrote an article titled “Gummihandschuhe in der chirurgischen praxis” (“Rubber Gloves in Surgical Practice”). In this article, he detailed his initial hunch about the limitations of merely washing one’s hands, but then went into more detail about all of the operations he had used gloves for thus far, and how they impacted his efficiency as a surgeon. Namely, the gloves available to him at that time didn’t allow for comfortable movement of his thumbs when using instruments with scissor-like handles.

In his conclusion, he was reluctant to predict their use by war surgeons due to the difficulty of keeping them sterile in the field, but he said, “They will be appreciated by the country doctor, who can comfortably carry them [wrapped] in a sterile towel in a glass jar... the boiled rubber glove guarantees an absolutely germ-free hand.”

Von Manteuffel’s thoughts on war medicine were not isolated. He served in the Estonian War of Independence, for which he was awarded the Vabadusrist (Cross of Liberty). He was also a physician to Tsar Nicholas II.

In the decades after von Manteuffel’s article, surgical gloves were widely discussed and their use became more widespread, with cleanliness as a primary motive. For instance, medical historian Dr. Thomas Schlich, from McGill University, writes of how, at the 1889 Congress of the German Society for Surgery, surgeons argued over the use of gloves by surgeons. They also compared which glove designs would best facilitate dexterity in surgical procedures.

Considering the use of disinfectants like carbolic aid in the 1860s, Dr. Schlich points to how gloves were a continuation of several technologies used to inhibit pathogenic organisms and sepsis. Over time, methods of glove sterilization were refined to mitigate deadly infec­tions. So too was the manufacturing of gloves, so that disposable latex gloves were de rigueur by the mid 1960s.

Today, the most popular disposable surgical gloves are still those made from the latex of rubber trees. With latex allergies in mind, however, alternatives are used. Notably, since 2008, Johns Hopkins Hospital has stopped using almost all latex products, including gloves. They’ve opted for “sterile neoprene and polyisoprene gloves” that are more expensive but “have a more sensitive feel.”

Changing materials aside, in 2007, in recognition of what would have been his 150th birthday, Eesti Post issued a commemorative stamp and postcard for von Manteuffel. The village society of Määri marked the occasion with the unveiling of a memorial stone, speeches, a blessing from a local church congregation’s clergyman, and music from a woodwind band.

Though the effort to bring surgical glove use into the mainstream was by no means achieved by any solitary doctor, von Manteuffel’s advocacy has helped to save an untold number of lives in a way that continues to this day.

Werner Zoege von Manteuffel (third from the left in the foreground) delivering a lecture, 1900.

Photo: dspace.ut.ee