John Bowie and the Edinburgh Pre-Set Tray System

Bacteriologists at the Royal Infirmary Edinburgh made an important contribution to improving hospital infection control in the mid twentieth century. DrJohn Herbertson Bowie, hospital bacteriologist and Chair of its Infection Control Committee in the 1950s and 1960s, was concerned about the continued hospital use of outdated sterilising apparatus:

‘Most of the apparatus already installed in the country is obsolete and represents all stages since 1870 in the development of efficient instruments by Germany, America and Switzerland. With this obsolete equipment (e.g. absence of an automatic chamber air and condensation discharge channel, complete with thermometer) no one could assure sterility in the routine preparation of surgical and pharmaceutical supplies – no matter how conscientiously the apparatus is operated – without causing excessive and unnecessary damage to heat sensitive supplies.’

John Herbertson Bowie, 1909-1984Bowie’s concern over the poor design and maintenance of sterilisers, as well as the problem of antibiotic-resistant staphylococci, led him to the view that the simple replacement of equipment would not be enough to ensure effective sterility.

Following his study of sterilisation practices in Europe and North America, he introduced the ‘Pre-set Tray System’ of instruments at Edinburgh.

The System, prepared by the Theatre Service Centre, supplied surgeons with all the sterile instruments they would require for a particular procedure on a specially-designed tray. The tray was covered with a drape before being sterilised and delivered to theatre, ready for use.

The Edinburgh Pre-Set Tray System was widely admired and similar systems were adopted in hospitals around the world.

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