The Evolution of Wound Closure
1650 BC - 1990s AD

The origins of surgery can be traced back many centuries.
Through the ages, practitioners have used a wide range
of materials and techniques for closing tissue.



Smith Papyrus
This Egyptian papyrus, circa 1650 BC, is the oldest known
medical text in existence. Tranlated in the 1920's, the
papyrus consisted of 48 clinical cases reported in heiroglyphics.



Ants
In the tenth century BC, the ant was held over the wound
until it seized the wound edges in its jaws. It was then
decapitated and the ant's death grip kept the wound closed.



Thorns
The thorn, used by African tribes to close tissue,
was passed through the skin on either side of the wound.
A strip of vegetable fiber was then wound
around the edge in a figure eight.



Cautery
Cautery has been used for centuries to stop bleeding.
Once, a red-hot iron was pressed into the wound.
Today, modern cautery is applied in many surgical procedures.



Fibulae (metal clasps)
These Greek and Mycenaean specimens, used to hold
tissue together, are thought to have been introduces
some 400 years after Hippocrates.



Needles
In a French manual published in 1858, Dr. Joseph Marie Goffres
illustrated how needles were used as skewers.
Surgical sutures were wound around needles and the tips
of the needles snipped off for safety.



Flax and Hemp
To seal off blood vessels, the Hindus made suture
material from plant fibers, such as hemp or flax.



Sterilized Catgut
The tough membrane of sheep intestine was provided
to the surgeon pre-sterilized and required threading
through the eye of the needle before use.



The Hultl Stapler
Developed in 1908 by Humer Hultl for stomach and
intestinal surgery, the stapler weighed eight pounds
and required two hours to assemble and load.



Swaged-on Needles
Post World War II brought the swaged-on needle.
The thread fits into the hollow end of the needle,
allowing it to pass through tissue without the double
loop of thread that exists with a conventional needle.
As a result, tissue trauma is reduced.
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