From mud and vinegar to 3D printing skin, the way we treat wounds still challenges humanity

By Sarah Maddocks, Cardiff Metropolitan University

Whether it’s the sting of a paper cut or the trauma of battle injury, wounds are woven into the tapestry of human experience. And since ancient times, we’ve fought the enemy that lurks within them – infection.

The constant threat of injury on the battlefield led to the search for new ways to combat wound infection. But early surgical procedures lacked the sterile instruments available today, meaning that for many years, surgery came with the added risk of post-operative wound infection, resulting in high numbers of deaths.

Ancient practices, such as using oils, mud, turpentine, or honey to treat wounds, were common around 2000BC. The Greek physician Hippocrates (460-377BC) used vinegar to clean wounds, followed by bandaging to keep dirt at bay.

While the first hospitals were established in Europe in the middle ages, they were dangerous and brutal places. Wound infection rates were high because of unsanitary conditions and the use of cautery, which involved pushing a burning iron into a patient’s wound until it reached the bone.

By the 1860s, the pioneering surgeon Joseph Lister had revolutionised wound infection treatment by introducing carbolic-acid-soaked bandages. And Robert Wood Johnson, who founded Johnson & Johnson, produced the first sterile gauze bandages by 1890. The combination of antiseptic and sterile bandage marked a turning point in the evolution of wound treatment and infection control.

The discovery of penicillin by Alexander Fleming in 1928 was also a pivotal moment in the treatment of wound infections. By the 1940s, penicillin was being used to treat second world war soldiers who had wound infections that would have been deemed fatal in previous years. For less serious wounds, Lister’s approach of using a dressing and an antiseptic was still used.

Substances like silver and iodine have also been recognised for their antimicrobial properties since the 1800s. Iodine, though effective, caused pain and skin discolouration until safer and less painful formulations were developed in 1949. These formulations endure in modern wound dressings.

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