Sessione Video Forum Johnson & Johnson Medical PERCORSI D'INNOVAZIONE PER LA CHIRURGIA

Many health care advances that have shaped modern life have their origins at Johnson & Johnson,

founded by three brothers in 1886.

To tell that story, we have to go back to the beginning, in 1861,

at the start of the American Civil War.

Crystal Lake, Pennsylvania.

A family with 11 children and two sons already in the Union Army

wanted to keep their third son safe and out of the conflict.

So they sent 16-year-old Robert Wood Johnson to apprentice

in the apothecary shop owned by relatives in upstate New York.

Their decision changed the course of young Robert's life.

His apprenticeship turned into a lifelong mission to improve health care.

In 1873, Robert Wood Johnson, now 28 years old,

formed a medical products business with a man named George Seabury.

In 1876, the United States celebrated its 100th birthday

with the Centennial Exhibition, a World's Fair in Philadelphia, Pennsylvania.

Pennsylvania. Robert attended, representing Seabury and Johnson. While he was there, Robert

heard a lecture given by the noted English surgeon Sir Joseph Lister. In the 1860s, operating

rooms were not sterile and surgical survival rates were tragically low. Lister had taken

Louis Pasteur's discovery that invisible germs cause infection and applied it for the first

time to surgery. Lister's radical idea that surgery should be sterile inspired the now

31-year-old Robert Wood Johnson with a new business opportunity to manufacture the first

mass-produced sterile surgical dressings and sterile sutures and save the lives of surgery

patients. Robert Wood Johnson's business partner was reluctant to take a chance on the risky

new innovation of making sterile surgical products. So in 1885, Robert and his young

brothers James and Edward Mead left and made plans to start their own company. January

January of 1886 found James Wood Johnson on a train from New York to Philadelphia.

When the train stopped in New Brunswick, he noticed a For Rent sign on a small four-story

former wallpaper factory near the railroad tracks.

Getting off the train to take a closer look, he rented it for Johnson & Johnson.

The little startup began with just 14 employees, founded on the revolutionary innovation of

mass-producing sterile surgical dressings, sterile sutures, and of promoting antiseptic

surgery as a way of saving lives. The new company in 1886 offered a very different business

philosophy of the day, one of openness and transparency, of responding to needs in society

and a working partnership with the medical profession. We are all fortunate in that we

are engaged in manufacturing products to be used throughout the world for the relief of pain and

suffering. Robert Wood Johnson. The first products were medicinal plasters which delivered medicine

directly through the skin sterile surgical dressings and sterile sutures

came next followed by one consumer product a tooth cream called Zahnweiss

meaning white teeth in German Robert would walk through the town of New

Brunswick striking up conversations with the local business owners on one such

occasion he entered the Opera House pharmacy and took an immediate liking to

the pharmacist Fred B Kilmer Johnson and Kilmer shared an interest in Sir Joseph

Lister's theories and a passion to improve health care eventually Robert

persuaded him to join Johnson and Johnson where Kilmer became the

scientific director from 1889 to 1934 working closely with the Johnson

brothers Kilmer helped set Johnson and Johnson on the path it follows today

from the beginning the Johnson brothers were astute in using information to grow

the business in 1888 Johnson and Johnson published modern methods of antiseptic

wound treatment, a how-to manual on sterile surgery with articles by the leading antiseptic

surgeons of the day. As the need evolved to sterilize our mass-produced surgical products,

Johnson & Johnson pioneered steam sterilization in 1891. The mass-produced sterile surgical

products caused a revolution in surgery, changing it from a last resort to a mainstay in the

treatment of injury and disease. Johnson & Johnson brought sterile surgery to the United States

and across the world. Johnson & Johnson expanded rapidly with success leading to

new products, many as a result of consumer feedback. When Fred Kilmer heard

that a doctor's patient was complaining of irritated skin after removing a

medicated plaster, Kilmer sent the doctor a small container of talc to soothe the

patient's skin. A container of talc was then included with some plasters made to

alleviate any irritation. Consumers replied that not only did the powder

soothed the irritation from the plasters it also soothed their baby's diaper rash

so in 1894 Johnson's baby powder was put on the market giving birth to our baby

products business the tradition continued with a medical need

facilitating the beginning of a successful product in 1920 the wife of a

Johnson & Johnson employee named Earl Dixon was clumsy in the kitchen and

during minor cuts and scratches while cooking Earl had the idea to create a

ready-made bandage to aid in his wife's healing. Although they're a part of

everyone's medicine cabinet today, band-aid brand adhesive bandages were

originally such a new concept that nobody knew how to use them. First aid

became a great need in the country, spurred on by the building of the

Transcontinental Railroad in the late 1800s. While traveling through the Rocky

Mountains by train, Robert Wood Johnson struck up a conversation with the

railway surgeon. The surgeon said that railroad workers were often injured from

accidents in remote areas and far away from medical help Robert listened and in

response Johnson & Johnson created the first first aid kits these were followed

in 1901 with the first first aid manuals researched and written by Fred Kilmer as

the new year of 1910 began Johnson & Johnson was almost 25 years old the

company continued to expand with growing product lines and a thriving export

sport business. Therefore, the sudden passing of company founder Robert Wood Johnson that January,

after a brief and unexpected illness, came as a shock. Fred Kilmer, in writing about his good

friend, said, When once convinced that an article which he could manufacture would save life

and prevent suffering, he caused it to be manufactured and placed before the medical

profession, irrespective of any consideration of profit. James Wood Johnson took over as president.

He and the management team his brother had put in place ensured that Johnson & Johnson continued with the same business philosophy of putting patients and consumers first.

Following his father's death, Robert's teenage son, also named Robert Wood Johnson, joined the company full-time, beginning as a mill hand in the company's powerhouse.

Robert shared his father's passion. He worked hard and learned quickly. Developing an easy rapport with the workers, they adopted him as one of their own.

In 1911, the company was producing 90% of all the cotton, gauze, and bandages used throughout the world.

A decade later, with the understanding of how important a global economy would be in health care,

young Robert and his brother Seward took a year-long worldwide research trip to assess business conditions.

Robert strongly believed that global decentralized expansion would help us grow into the future.

He knew that locally managed operating companies were closer to their customers and markets

and it served his motto be as local as you can be Robert moved into the leadership role at Johnson

and Johnson when his uncle James retired in 1932 his leadership began during the depths of the

Great Depression when a sense of the world was greatly changed Robert held fast to the fundamental

business philosophy and governing values put in place by his father and uncles and steered the

company successfully through this dark time his outspoken philosophy and his leadership attracted

the notice of President Roosevelt. During World War II, Johnson was made a

Brigadier General and appointed by Roosevelt to lead the smaller War Plants

Corporation in Washington DC. During the Industrial Era, Johnson was a lone voice

talking about corporate social responsibility, and yet he would not be

deterred. He continued to think, write, and speak openly about the social

responsibilities of business. Out of the suffering of the past few years has been

been born a public knowledge and conviction that industry only has the right to succeed

where it performs a real economic service and is a true social asset. It is to the interest

of modern industry to realize that service to its customers comes first, service to its

employees and management second, and service to its stockholders last. General Robert Wood

Wood Johnson in 1943 Johnson published this set of principles as our credo he

declared that moving forward our credo would be the guiding principles within

the company's philosophy putting patients and consumers employees and the

community before our final responsibility to our stockholders our

credo became the heart of the culture within Johnson and Johnson it was in

1963 that Robert Wood Johnson stepped down as chairman and CEO he had left an

indelible mark his successors have continued to increase our capacity to meet unmet needs in human

health and care for the community legacy that goes back to the beginning of the company during the

spanish-american war the military asked johnson and johnson to develop and manufacture surgical

dressings to treat wounded soldiers when the need exceeded what the army had contracted with us to

produce the management of johnson and johnson supplied additional dressings at no cost

because they were needed to save lives two years later when a devastating

hurricane struck Galveston Texas Johnson & Johnson sent products and money to

help the survivors within hours of the San Francisco earthquake in 1906 real

cars filled with Johnson & Johnson products were speeding to the west coast

along with financial support our human response to these events marked the

beginnings of our tradition of worldwide disaster relief and our global

humanitarian efforts several decades ago the community of New Brunswick was

suffering a decline during this period our company had to decide where to

locate the new world headquarters being built the decision made was based on our

credo commitment and Johnson & Johnson remained in New Brunswick forming a

public-private partnership to revitalize the city which has since become a

national model our heritage helping the community also includes our tradition of

of employee volunteers going back over 100 years,

and it remains one of the traditions that unites

our employees around the world.

From our founding in 1886 to our broad base

in human health care today, Johnson & Johnson

continues to look for ways to save and improve lives.

When we began, the great needs were

for mass-produced sterile surgical products, first aid,

and basic public and family health.

As the decades passed, Johnson & Johnson grew and decentralized, expanding into new areas of health and technologies, identifying human needs and pioneering the development of products and businesses to meet them.

Today, we continue to meet human healthcare needs in ways that the Johnson brothers and the first 14 employees who started our journey couldn't even begin to imagine.

As we continue to build on their legacy, future generations at Johnson & Johnson will continue to care for the world in ways that we cannot even begin to imagine today.

The world will continue to be healed, one person at a time, and the human element inherent in that makes all the difference.

Millions of surgical interventions are carried out, and in each of them the sutures play a fundamental role.

Etikon has built its image by making innovative sutures that exceed normal quality and innovation standards.

But you already knew this!

In this series of three videos we will use the microscope to discover how Etikon sutures are really made and how, thanks to the premium needles, advanced packaging and constant performance, our sutures have become the reference product for the closure of wounds for surgeons.

this is beyond legacy the first video beyond thread today on beyond legacy we will take a look at how

etikon creates one of the most critical and reliable parts of a suture the thread etikon is a reference

for surgery has always produced sutures before I started doing surgical interventions

over the years I have used and continue to use their products appreciating

the reliability day after day by sharing the same judgment of those who taught me the art

of the surgery every year etikon produces material able to wrap the earth 12 15 times

it is a huge amount especially if you consider the care and craftsmanship with

which it is made and the laboratory work for the production of each single thread even if

etikon produces all over the world we will start our journey beyond legacy in a

georgian American plant this is where the production of etikon sutures begins I went

there and it was so fascinating to see how difficult the delicacy used

especially for the smallest calibers and how much individual work is spent in

each of them the sutures are designed at a molecular level

different chemical components and production processes determine the

property of a thread each is designed for a certain function and

tissue level the sutures designed can be

be absorbable or non-absorbable, braided, monofilament or fishing line

based on the use of the surgeon. These different typologies are generally

made in five main stages that vary according to the type of suture,

guaranteeing at the same time all rigorous controls provided by Etikon

to guarantee quality on a global scale and reliability. The first step is the

synthesis of polymers. This happens when a monomer becomes a polymer.

you can think of a monomer as a single unit then you take the different monomers and

polymerize them by building very long chains that represent the polymer polymer means in fact

many units ethical works with four different monomers that once heated and combined in

polymers offer different properties after the polymerization the compound is made up of pellets

The fused polymer is inserted in a pelletizer where it hardens to then be cut into small pellets in order to facilitate the transfer to the next phase.

Extrusion

So far, nothing we have seen looks like a thread. Extrusion occurs when the materials literally take shape.

form. First of all, the polymer pellets are convolved through a conduct called

cochlea that transports them to a mold to extrude the polymer into fibers. It's like making spaghetti.

The fiber is then stretched and rolled at different speeds. This is where the various properties,

such as resistance to traction, are imprinted in the fibers. It's like making spaghetti,

but very important spaghetti. The control care that each operator applies

to follow our recipes properly is an impressive process the

absorbable sutures have a limited number of days between the extrusion process and the arrival

of a finishing system otherwise the suture becomes unusable we have to transfer the

material through the production process and in a certain period of time otherwise it is thrown

away the fibers remain monofilament for an atraumatic sliding through the fabric

or they are braided to create multifilament sutures the morphology of the braid allows the

thread to conform and adapt to the tissue variations important qualities for fabrics

that expand and contract while maintaining strength and safety at the same time if you think of

a suspended bridge the cables that surround the bridge are not built from a single piece but are

bands of cables this structure allows the bridge structure to have a greater ability to move and

adapt this takes a long time on the machine for braiding the thread runs for ten days forming

braids a lot of machines are needed all used consecutively for ten days to

make a suture game some sutures are coated here the last touches are added

such as lubrication or a special antibacterial coating used to create

the sutures plus the sutures plus have shown to inhibit the bacterial colonization of the

thread for seven days or more what do you think of this finish the thread is now ready to

leave the implant to be attached to the needle then packaged and delivered to the operating room

where it will perform its life-saving functions in etikon a thread goes beyond a simple fiber

is the culmination of technical skill experience and commitment to the superior quality of

dei propri prodotti che distribuisce in sala operatoria se mi dai un piatto di ingredienti

e viene a casa mia per cena o vai a casa di wolfgang pack con gli stessi ingredienti si

ottiene un piatto molto molto diverso pertanto delle nostre mani gli stessi materiali di partenza

gli stessi polimeri gli stessi processi generali possono portare un piatto molto molto diverso

durante l'intervento chirurgico alla fine della giornata con tutta la tecnologia che abbiamo a

our disposal 90 percent of the problems we have to deal with are

attributable to the suture we become really dependent on these sutures to

manage these problems hoping that for you it was interesting

to find out what's behind a thread we invite you to new discoveries in the

great thread deserves a great needle the development of needles and sutures must

have to go one step at a time when you reflect on the activity that you do day after day in your

work realize that you are not making a needle in reality you are changing the lives of patients

this puts your work in a completely different perspective in this series of videos divided

into three parts we will explore at the microscope how the etikon sutures are really produced and

how through the high quality needles advanced packaging system and

and constant performance levels

have become the product of reference of surgeons

in the closure of wounds

This is Beyond Legacy

Today on Beyond Legacy

Beyond the Point

Precision

Strength

Reliability

Quality

These are the distinctive traits of the Etikon needles

Their journey towards excellence begins here

in the production site of the Etikon metal threads

where every year the equivalent of the weight of 160 cars in metal wire is stretched, heated and wet

until it reaches a precise diameter that fully corresponds to our quality standards.

Edicon has developed the strongest steel ever made,

specifically for use on our lines of cardiovascular and plastic surgery.

For a cardiothoracic surgeon, the fact that we have created and worked to develop a Tungsten-Renio ligament

used to produce lago ever point that provides the superior and necessary resistance to

surgeons to pass repeatedly in the valve without the lake bending represent a

huge difference in some of the most complex surgical interventions now the

coils produced containing the metal wire are sent to the ethical structures present in

the whole world responsible for the production of the eels taper then spatula smussed tip

cutting edge what is mounted on your suture with neando rectifying curving and testing

ethical is able to produce a wide range of geometries of designed aghi to meet

the highly specific needs of surgeons there are times when I think I need a

cylindrical needle and I actually need a cutting needle to be able to have the right

combination of thread needle I think it is essential ethical aghi are subject to numerous

quality checks during all production processes which is a needle studied

to penetrate the skin or a fibrous fabric such as tendons or from the pointed tip made to

widen tissues such as coronary arteries without lacerating visual control systems at high

speed constantly monitor the design of the bridges if there is something that happens to the needle during

the process the control system immediately picks it up needles that end the process are

curved and laminated and sent for electro-glowing which nudes the excess material

from the needle, immersing it in acid, then adding electricity. The needles are then treated

with a lubricating coating to facilitate the passage through the fabric. Finally, penetration

tests conform to the higher level of sharpness and low penetration force

step by step. Now it is time for the needle to meet its natural partner, the thread. A hole

made with extreme precision is essential for the secure fixation to the thread this is not an

easy task if you consider how small these aghi are about three to six times the

size of a human hair and require a drill of the size of a eyebrow aghi like

the one developed with the ethyl steel alloy they need a very strong drill or in this

case a laser so when the laser hits the ends of the lake the energy totally concentrated

on that point is so large that the metal dissolves practically vaporizes the lasers

are able to create very precise holes and complete up to six eels per second speed

and precision at the same time once the hole has been made perfectly

responding to the quality standards the suture can be used the thread-wire locking system is

carried out through pressure in the terminal part of the lake the force held by thread-wire is

verified through specific tests so that the surgeons can trust the fact that every

passage will be safe when we have good products in our hands we are able to obtain

better results it is a direct and full of passion connection to these results

results that inspire all the people who daily produce etikon aghi you have a

family and they can also undergo interventions you don't know if you are using your ag or

sometimes they use it then realize how important it is to do your job well to produce

as best as possible hoping that it was interesting for you to find out what is behind a needle

600 million sutures and needles every year able to change millions of lives but his determination

in improving the quality of life goes beyond the product. Explore the extraordinary innovation

that characterizes each package of Etikon sutures, discover the commitment of Etikon in the

education process and its global community. Join us, explore beyond the box. The Etikon sutures

that I use in the hospital, the most important thing that comes to mind is reliability. It fills me with

confidence to know that I am using the best product on the market. I feel reassured

in knowing that the patient is protected through the use of the best sutures the

ethical sutures so how can ethical through every innovation to build a

bond of unprecedented trust begins with an idea an idea that arises from the analysis of

surgeons of the real needs of their patients the unsatisfied need is really what

is at the base of the work we do when we have these conversations with surgeons

from all over the world we find out what they really need from us this is what brings us

again in the laboratory. It is there that ETHICON works to develop concepts of

innovative products, studied specifically to satisfy unfulfilled needs.

The development process of the product in ETHICON is an extremely coordinated process

dynamic that involves input from multidisciplinary specialists from each department.

Working on the development of the product of ETHICON, you can appreciate how the

minimum details are followed, the amount of tests and re-tests and in general the attention that characterizes

the development of these products test collect evidence repeat again is the only way

to guarantee the surgeon to have the best possible product able to provide the best

possible result for his patients ethical makes a huge amount of homework before

making products available to us I think this bears witness to the real will to expand

the boundaries of product innovation forward anti-bacterial sutures aghi tungsteno regno

ecological packaging all this represents the will of etikon to expand the borders

once the concept of product is finalized it is brought to life packaged with care

and sent to the operating rooms all over the world end of the story right absolutely no

innovation and product instruction go hand in hand as soon as the new technology is

available we are committed to helping effectively to use products safely and

and effective to really go beyond beyond the box

etikon is committed to guarantee the best professional training at

worldwide level together with the training on sales their

teaching unit is one of the best in the world

they are extremely practical and efficient in the operating room they spend

days with us they are there to show us every single thing they are part

member of the medical team etikon recognizes that the commitment to

improve the life of the patient goes beyond the product and reaches the global community

etikon is our anchor of salvation etikon has helped us in the last 36 years through the

operation smile solidarity initiative we cannot go on a mission without them they are more than

a simple society they are our partners our first responsibility is towards doctors

nurses and patients towards mothers and fathers and towards all those who use

portfolio of knotless tissue control devices. Featuring Eficon's premium

needles, patented polymers, extensive code lists, multiple anchor designs and plus

antibacterial technology for every layer of closure. Now with over 170 codes only

Eficon can offer superior wound holding strength, exceptional needle performance,

proven plus antibacterial technology and various fixation devices for ease of use in open laparoscopic

and robotic procedures rounding out this portfolio is the stratific spiral knotless

tissue control device with plus antibacterial technology these unidirectional devices are

available in different lengths sizes and polymers designed for a wide range of surgical procedures

in both open and MIP and now they are being manufactured by Ethicon

leveraging our unmatched history of suture and needle expertise with the

most comprehensive and unmatched portfolio on the market only Ethicon can

offer more security more consistency and more efficiency than traditional sutures

for each layer of closure with the added benefits of Ethicon's well-known and

trusted polymers premium needles and proven plus antibacterial technology it's very nice to have

a suture you can just start suturing and keep moving you want a suture that's strong when you

put it in and stays strong stratafix has the big advantage of you don't have knots so it's a quicker

closure and it makes it so much easier to close those incisions and it can cut down on the length

of time of the procedure significantly so when i look at stratafix i look at the suture of the

the future. So that's what I call it. It's that good. Any case where I can use Stratafix,

19th century, scientists observed that adding oxygen to plant-based fabrics allowed them to

dissolve when placed into blood. This sparked an effort to develop an oxidized gauze that could be

completely absorbed by the body and improve surgical hemostasis beyond the rudimentary

techniques of the time. So before there was surgery cell and we're talking about

50 years ago surgeons just would control bleeding with regular cotton gauze or

lab sponges and as you know that's that's not always effective. In 1960

Johnson and Johnson scientists developed the first regenerated cellulose which

through a highly controlled oxidation process transformed the textile into a

fully absorbable hemostat and revolutionize surgical hemostasis. Today

Surgicel absorbable hemostats are the most widely used and trusted around the

globe and Surgicel technology continues to evolve both in delivery and

efficacy with Surgicel NuNet more densely woven for heavier bleeding

Surgicel Fibrillar offering 39% faster time to hemostasis and enhanced

versatility with a layered non woven structure that can be peeled apart for

precise placement in complex procedures and Surgicel Snow which has an

advanced felt like design that provides exceptional handling making ideal for

both minimally invasive and open procedures Surgicel Snow was the last

product that we launched in that category but it won't be the last one we

launched we continue to innovate on the Surgicel brand for more than 50 years

Surgicel has raised the bar in absorbable haemostasis, offering solutions that enable precise placement and effective haemostasis in increasingly challenging situations.

The fact that we can depend on their consistency as far as ease of use has allowed us to incorporate them into our procedures more efficiently.

It's really a wonderful brand and I'm very happy that I've been a part of it.

For the challenges of yesterday, today and tomorrow, there is the Surgicel family of absorbable hemostats.

achieved by combining high-quality raw materials with a controlled manufacturing process that applies to every Surgicel product.

product. First, wood pulp is transformed into regenerated cellulose, which is then knitted

into a fabric. Textile becomes a medical device through a highly controlled oxidation process.

The oxidation process is really critical in turning this common textile into a medical

product. It's what imparts its hemostatic capacity. It's what makes it absorbable, susceptible

to moisture and it's it's really the thoroughness and the quality of that

process that gives the surgeon confidence that when they've used this

and implanted it's going to go away all surgery said absorbable hemostats are

oxidized at a single facility using a precise formula and a special solvent

specialized equipment verifies that the oxidation process is followed exactly

and that the specifications like carboxyl content and purity standards are

strictly met. 12 quality assurance checkpoints confirm that each piece of

Surgicel is 100% oxidized, which ensures its complete bio-absorbability and

gives Surgicel industry-leading bactericidal efficacy. Finally, a

validated dehumidification process reduces moisture content before

packaging, guaranteeing that every piece of Surgicel will perform at its best

when needed. Process excellence means that each piece of Surgicel makes it

it from here to here with exceptional quality and dependability.

And that's why we've heard from surgeons year after year after year that whenever they open

a Surgicel they get the same material every time. It's because of those tight controls.

Surgeons around the world put their trust in Surgicel and Ethicon honors that trust

with unwavering dedication to excellence.

Hello I'm Dr. Ryan Lewis. I'm with Ethicon on the Megadyne team. This is the Megadyne

Megasoft reusable patient return electrode. It has a patient-centric design. There are

no adhesives, which eliminates adhesive-related injuries, and it can be used with patient

warming devices. The Megasoft pad is also radiolucent and latex-free. The pad is simply

placed under the patient, and a helpful diagram on the front shows how the pad can be used

with different OR table configurations and frames. The pad can also be used with bean

bags for positioning. The Megasoft patient return electrode can be used on

patients as small as 0.35 kilograms or neonatal patients all the way up to the

largest bariatric patients. There is no upper weight limit for this pad. The

Megasoft pad also reduces cost and waste in the operating room. It's reusable up

to 24 months and it's easy to clean in between procedures. You simply wipe the

pad down with an approved cleaning solution, followed by a water rinse.

Because the Megasoft pad is reusable, it's environmentally friendly and can reduce waste

from packaging and devices.

And because it can be used over a full range of patient weights, there's no need to order

different sizes of return electrodes.

It's also easy to set up.

There's no required skin prep, such as shaving, and it's compatible with major brands of electrosurgical

generators. The Megasoft Universal Pad can be used with either side up and can be positioned

so that the cord can be closest to the generator. The Megadyne Megasoft Universal Reusable Patient

Return Electrode also comes in a dual cord configuration, which allows for use of two

generators during a procedure. The Megadyne Megasoft Reusable Patient Return Electrode

technology has been used in more than 75 million procedures with zero pad site burns i hope this

overview provides you with the information you need to discuss this product at your upcoming

professional education course thank you for making a difference in our surgical training

founded by three brothers in 1886 to tell that story we have to go back to the beginning in

1861 at the start of the American Civil War Crystal Lake Pennsylvania a family

with 11 children and two sons already in the Union Army wanted to keep their

third son safe and out of the conflict so they sent 16 year old Robert Wood

Johnson to apprentice in the apothecary shop owned by relatives in upstate New

York their decision changed the course of young Roberts life his apprenticeship

turned into a lifelong mission to improve health care.

Robert attended, representing Seabury and Johnson.

While he was there, Robert heard a lecture given by the noted English surgeon,

surgeon, Sir Joseph Lister. In the 1860s, operating rooms were not sterile and surgical

survival rates were tragically low. Lister had taken Louis Pasteur's discovery that invisible

germs cause infection and applied it for the first time to surgery. Lister's radical idea

that surgery should be sterile inspired the now 31-year-old Robert Wood Johnson with a

new business opportunity to manufacture the first mass-produced sterile surgical dressings

and sterile sutures, and saved the lives of surgery patients.

Robert Wood Johnson's business partner was reluctant to take a chance

on the risky new innovation of making sterile surgical products.

So in 1885, Robert and his young brothers James and Edward Meade

left and made plans to start their own company.

When the train stopped in New Brunswick, he noticed a For Rent sign

on a small four-story former wallpaper factory near the railroad tracks.

The little startup began with just 14 employees,

founded on the revolutionary innovation of mass-producing sterile surgical dressings,

sterile sutures, and of promoting antiseptic surgery as a way of saving lives.

The new company in 1886 offered a very different business philosophy of the day,

one of openness and transparency of responding to needs in society and to

working partnership with the medical profession we are all fortunate in that

we are engaged in manufacturing products to be used throughout the world for the

relief of pain and suffering Robert Wood Johnson the first products were

medicinal plasters which delivered medicine directly through the skin

sterile surgical dressings and sterile sutures came next followed by one

consumer product, a tooth cream called Zahnweiss, meaning white teeth in German. Robert would walk

through the town of New Brunswick, striking up conversations with the local business owners.

On one such occasion, he entered the Opera House Pharmacy and took an immediate liking to the

pharmacist, Fred B. Kilmer. Johnson and Kilmer shared an interest in Sir Joseph Lister's theories

and a passion to improve health care. Eventually, Robert persuaded him to join Johnson & Johnson,

where Kilmer became the scientific director from 1889 to 1934.

Working closely with the Johnson brothers,

Kilmer helped set Johnson & Johnson on the path it follows today.

From the beginning, the Johnson brothers were astute

in using information to grow the business.

In 1888, Johnson & Johnson published

Modern Methods of Antiseptic Wound Treatment,

a how-to manual on sterile surgery

with articles by the leading antiseptic surgeons of the day.

As the need evolved to sterilize our mass-produced surgical products, Johnson & Johnson pioneered steam sterilization in 1891.

The mass-produced sterile surgical products caused a revolution in surgery, changing it from a last resort to a mainstay in the treatment of injury and disease.

Johnson & Johnson brought sterile surgery to the United States and across the world.

Johnson & Johnson expanded rapidly, with success leading to new products,

many as a result of consumer feedback when Fred Kilmer heard that a doctor's patient was

complaining of irritated skin after removing a medicated plaster Kilmer sent the doctor a small

container of talc to soothe the patient's skin a container of talc was then included with some

plasters made to alleviate any irritation consumers replied that not only did the powder soothe the

irritation from the plasters it also soothed their baby's diaper rash so in 1894 Johnson's

baby powder was put on the market giving birth to our baby products business the

tradition continued with a medical need facilitating the beginning of a

successful product in 1920 the wife of a Johnson & Johnson employee named Earl

Dixon was clumsy in the kitchen and during minor cuts and scratches while

cooking Earl had the idea to create a ready-made bandage to aid in his wife's

healing although there are part of everyone's medicine cabinet today

Band-Aid brand adhesive bandages were originally such a new concept that nobody knew how to use them.

First aid became a great need in the country, spurred on by the building of the Transcontinental Railroad in the late 1800s.

While traveling through the Rocky Mountains by train, Robert Wood Johnson struck up a conversation with the railway surgeon.

The surgeon said that railroad workers were often injured from accidents in remote areas and far away from medical help.

Robert listened and in response Johnson & Johnson created the first first aid kits these were

followed in 1901 with the first first aid manuals researched and written by Fred Kilmer as the new

year of 1910 began Johnson & Johnson was almost 25 years old the company continued to expand with

growing product lines and a thriving export business therefore the sudden passing of company

founder Robert Wood Johnson that January after a brief and unexpected illness

came as a shock Fred Kilmer in writing about his good friend said when once

convinced that an article which he could manufacture would save life and prevent

suffering he caused it to be manufactured and placed before the

medical profession irrespective of any consideration of profit James Wood

Johnson took over as president he and the management team his brother had put

put in place, ensured that Johnson & Johnson continued with the same business philosophy

of putting patients and consumers first.

Following his father's death, Robert's teenage son, also named Robert Wood Johnson,

joined the company full time, beginning as a mill hand in the company's powerhouse.

Robert shared his father's passion.

He worked hard and learned quickly, developing an easy rapport with the workers, they adopted

him as one of their own.

he knew that locally managed operating companies were closer to their customers

and markets and it served his motto be as local as you can be Robert moved into

the leadership role at Johnson & Johnson when his uncle James retired in 1932 his

leadership began during the depths of the Great Depression when a sense of the

world was greatly changed Robert held fast to the fundamental business

philosophy and governing values put in place by his father and uncles and

and steered the company successfully through this dark time.

His outspoken philosophy and his leadership attracted the notice of President Roosevelt.

During World War II, Johnson was made a Brigadier General and appointed by Roosevelt to lead

the smaller War Plants Corporation in Washington, D.C.

During the industrial era, Johnson was a lone voice talking about corporate social responsibility,

and yet he would not be deterred.

he continued to think write and speak openly about the social responsibilities of business

out of the suffering of the past few years has been born a public knowledge and conviction that

industry only has the right to succeed where it performs a real economic service and is a

true social asset it is to the interest of modern industry to realize that service to its customers

comes first service to its employees and management second and service to its

stockholders last general Robert Wood Johnson in 1943 Johnson published this

set of principles as our credo he declared that moving forward our credo

would be the guiding principles within the company's philosophy putting

patients and consumers employees and the community before our final

responsibility to our stockholders our credo became the heart of the culture

within Johnson and Johnson. It was in 1963 that Robert Wood Johnson stepped down as chairman and

CEO. He had left an indelible mark. His successors have continued to increase our capacity to meet

unmet needs in human health and care for the community, a legacy that goes back to the

beginning of the company. During the Spanish-American War, the military asked Johnson and Johnson to

develop and manufacture surgical dressings to treat wounded soldiers. When the need exceeded

with the army had contracted with us to produce, the management of Johnson & Johnson supplied

additional dressings at no cost, because they were needed to save lives.

Two years later, when a devastating hurricane struck Galveston, Texas, Johnson & Johnson

sent products and money to help the survivors. Within hours of the San Francisco earthquake

in 1906, rail cars filled with Johnson & Johnson products were speeding to the West Coast along

with financial support.

Our human response to these events marked the beginnings of our tradition of worldwide disaster relief and our global humanitarian efforts.

Several decades ago, the community of New Brunswick was suffering a decline.

During this period, our company had to decide where to locate the new world headquarters being built.

The decision made was based on our Credo commitment, and Johnson & Johnson remained in New Brunswick,

forming a public-private partnership to revitalize the city,

which has since become a national model our heritage helping the community also

includes our tradition of employee volunteers going back over 100 years and

it remains one of the traditions that unites our employees around the world

from our founding in 1886 to our broad base in human health care today Johnson

& Johnson continues to look for ways to save and improve lives when we began the

The great needs were for mass-produced sterile surgical products, first aid, and basic public

and family health.

As the decades passed, Johnson & Johnson grew and decentralized, expanding into new areas

of health and technologies, identifying human needs and pioneering the development of products

and businesses to meet them.

Today, we continue to meet human health care needs in ways that the Johnson brothers and

the first 14 employees who started our journey couldn't even begin to imagine

as we continue to build on their legacy future generations at Johnson & Johnson

will continue to care for the world in ways that we cannot even begin to

imagine today the world will continue to be healed one person at a time and the

human element inherent in that makes all the difference

play a fundamental role etikon has built its image by making innovative sutures

that exceed the normal standards of quality and innovation but you already knew this in this

series of three videos we will use the microscope to find out how the etikon sutures are really made

and how, thanks to the Aghi Premium, advanced packaging and constant performance,

our sutures have become, for surgeons, the product of reference for the closure of wounds.

This is Beyond Legacy, the first video Beyond Thread.

Today, on Beyond Legacy, we will take a look at how Eticon creates one of the most critical and reliable parts of a suture, the thread.

Ethicon is a reference for surgery since forever. It produced sutures before I started doing surgical interventions.

Over the years I have used and continue to use their products, appreciating their reliability day after day,

sharing the same judgment of those who taught me the art of surgery.

Each year Ethicon produces material capable of wrapping the earth 12-15 times.

It is a huge amount, especially if you consider the care and craftsmanship with which it is made

and the laboratory work for the production of each single thread even if etikon produces

all over the world we will start our journey beyond legacy in a US plant in

georgia this is where the production of etikon sutures begins I went there and it was so fascinating to

see how difficult the delicacy used especially for the smallest calibers is and how much

individual work is spent on each of them the sutures are designed at

molecular level various chemical components and production processes

determine the property of a thread each is designed for a certain

function and tissue level the sutures designed can be

absorbable or non-absorbable braided monofilament or fishing line

based on the use of the surgeon these different types are generally

made in five main stages that vary depending on the type of suture

guaranteeing at the same time all the rigorous controls provided by ETHICON

to guarantee quality on a global scale and reliability.

The first step is the synthesis of polymers.

This happens when a monomer becomes a polymer.

You can think of a monomer as a single unit,

then you take the different monomers and polymerize them,

building very long chains that represent the polymer.

Polymer means, in fact, many units.

ETHICON works with four different monomers

that once heated and combined in polymers offer different properties after the polymerization

the compound is made up of pellets the fused polymer is inserted in a pelletizer where it

hardens and then is cut into small pellets in order to facilitate the transfer to the

next phase the extrusion so far nothing we have seen looks like a

to a thread the extrusion occurs when the materials literally take shape first of all

the polymer pellets are convolved through a conduct called cochlea which

transports them to a mold to extrude the polymer into fibers and how to make spaghetti the fiber

is then stretched and rolled at different speeds and here the various properties such as

the resistance to traction are impressed in the fibers it is like making spaghetti but

very important spaghetti the care of the control that each of the operators applies to follow

our recipes appropriately is an impressive process the absorbable sutures have a

limited number of days between the extrusion process and the arrival of a finishing plant

otherwise the suture becomes unusable we have to transfer the material through the

production process and in a certain period of time otherwise it is thrown away the fibers

remain monofilament for an atraumatic sliding through the fabric or are braided

to create multi-filament sutures the morphology of the braid allows the thread to conform and

adapt to the tissue variations important quality for fabrics that expand and

they contract while maintaining strength and safety at the same time if you think of a suspended bridge

the cables that surround the bridge are not built from a single piece but are bundles of cables this

structure allows the bridge structure to have a greater ability to move and adapt this

takes a long time on the machine for braiding the wire runs for ten days forming braids

several machines are needed all used consecutively for ten days to make a

a suture game some sutures are covered here the last touches are added such as

lubrication or a special antibacterial coating used to create the

sutures plus the sutures plus have shown to inhibit the bacterial colonization of the

thread for seven days or more what do you think of this finish the thread is now ready to leave the

impianto essere attaccato al lago poi confezionato e consegnato alla sala

operatoria dove svolgerà le proprie funzioni salvavita in eticon un filo va

al di là di una semplice fibra è il culmine di abilità tecnica l'esperienza

e l'impegno per la qualità superiore dei propri prodotti che distribuisce in

sala operatoria se mi dai un piatto di ingredienti e

viene a casa mia per cena o vai a casa di wolfgang pack con gli stessi

ingredients you obtain a very very different dish therefore in our hands the same

starting materials the same polymers the same general processes can bring a

very very different dish during the surgical intervention at the end of the day with all

the technology we have at our disposal 90 percent of the problems we have to

deal with are attributable to the suture we become really dependent on these sutures to

manage these problems hoping that for you it was interesting to find out what

is behind a thread we invite you to new discoveries in the next episodes of

large needle the development of needles and sutures must go hand in hand when

you reflect on the activity you do day after day in your work realize that

you are not making a needle in reality you are changing the lives of patients

constant performance levels have become the reference product of surgeons in

nelle chiusure delle ferite questo è beyond legacy oggi su beyond legacy beyond the point precisione

forza affidabilità qualità questi sono i tratti distintivi degli aghi etikon il loro viaggio verso

l'eccellenza inizia qui nel sito produttivo dei fili metallici etikon dove ogni anno l'equivalente

del peso di 160 automobili in filo metallico viene allungato riscaldato e bagnato fino a

reach a precise diameter that fully corresponds to our quality standards

etikon has developed the strongest steel ever made specifically for use on

our lines of cardiovascular and plastic surgery for a

cardiologist the fact that we have created and worked to develop a

tungsten-oranium alloy used to produce the everpoint alloy that provides the

superior and necessary resistance to surgeons to repeatedly pass through the valve

without the alloy bending represents a huge difference in some of the

more complex surgical interventions now the coils produced containing the metal wire

are sent to the ethical structures present all over the world responsible for the production

of the eels taper then spatula smussed tip cutting edge what is mounted on your suture

conning rectifying curving and testing ethical is able to produce a wide range of geometries

of eels designed to meet the highly specific needs of surgeons there are

There are moments when I think I need a cylindrical needle and I actually need a cutting needle.

Being able to have the right combination of needle and thread is fundamental.

Ethicons are subject to numerous quality checks during all production processes,

whether it is a needle studied to penetrate the cuticle, or a fibrous fabric such as tendons,

or from the pointed tip made to widen tissues such as coronary arteries without lacerating them.

High-speed visual control systems constantly monitor the design of the bridges.

If there is something that happens to the needle during the process, the control system immediately detects it.

The needles that finish the process are curved and laminated and sent for electrolucidation,

which nudes the excess material from the needle by immersing it in acid, then adding electricity.

The needles are then treated with a lubricating coating to facilitate the passage through the fabric.

finally the penetration tests conform to the higher level of sharpness and the low

penetration force step by step now is the time for the needle to meet its

natural partner the thread a hole made with extreme precision is essential for

secure fixation to the thread this is not an easy task if you consider how small

these needles are about three to six times the size of a human hair and require a

trapano delle dimensioni di un ciglio aghi come quello sviluppato con la lega

di acciaio et aloe necessitano di un trapano molto forte o in questo caso un

laser così quando il laser colpisce le

estremità del lago l'energia totalmente concentrata su quel punto è così grande

che il metallo si scioglie praticamente si vaporizza i laser sono in grado di

creare fori molto precisi ea completare fino a 6 aghi al secondo velocità e

precision at the same time once the hole has been made perfectly

responding to the quality standards can accommodate the suture the system of

blockage thread needle is made by pressure in the terminal part

of the lake the force held thread needle is verified by specific tests

so the surgeons can trust in the fact that every passage will be safe

when we have good products in our hands we are able to obtain

better results it is a direct connection and full of passion for these results results

that inspire all the people who daily produce the etikon aghi you have a family

and they can also undergo interventions you do not know if your needle is being used or not sometimes

they use it then realize how important it is to do your job well to produce as well as possible

Sperando che per voi sia stato interessante scoprire cosa c'è dietro un ago, vi invitiamo

a nuove scoperte nei prossimi episodi di Beyond Legacy.

Etikon produce più di 600 milioni di suture e di aghi ogni anno, in grado di cambiare

milioni di vite, ma la sua determinazione nel migliorare la qualità di vita va oltre

il prodotto.

Esplora la straordinaria innovazione che caratterizza ogni confezione di suture Etikon, scopri

l'impegno di etico nel processo di educazione e la sua comunità globale unisciti a noi esplora

beyond the box le suture etico anche uso in ospedale la cosa più importante che viene in

mente è l'affidabilità mi riempie di fiducia sapere che sto utilizzando il miglior prodotto

presente sul mercato mi sento rassicurata nel sapere che il paziente sia tutelato attraverso

l'utilizzo delle migliori suture le suture etico quindi come riesce etico attraverso ogni

innovation to build a bond of trust without precedents begins with an idea an idea that

arises from the analysis of the surgeons of the real needs of their patients the unsatisfied need

is really what is at the base of the work we do when we have these conversations with

surgeons from all over the world we find out what they really need from us this is what

brings us back to the laboratory and there that ethical works to develop concepts of

The development process of the product in ETHICON is an extremely dynamic coordination process

that involves input from multidisciplinary specialists from each department.

Working on the development of the ETHICON product, you can appreciate how the

minimum details are followed, the amount of tests and re-tests and in general the attention that

characterizes the development of these products. Testing, collecting evidence,

to repeat again is the only way to guarantee the surgeon to have the best possible product

able to provide the best possible result for his patients ethical makes a huge

amount of homework before making products available to us I believe that

this bears witness to the real will to expand the boundaries of product innovation forward

antibacterial sutures aghi tungsteno regno ecological packaging all this represents the

will of etikon to expand the boundaries once the concept of product is

finalized it is brought to life packaged carefully and shipped to

operating rooms all over the world end of the story right absolutely no

innovation and product instruction go hand in hand as soon as the

new technology is available we are committed to helping effectively

to use products in a safe and effective way to really go beyond

Beyond the box, ETHICON is committed to guarantee the best professional training

worldwide, together with the training on sales. Their teaching unit is one of the

best in the world, they are extremely practical and efficient in the operating room, they spend days

with us, they are there to show us every single thing, they are an integral part of the medical team.

ETHICON recognizes that the commitment to improve the life of the patient goes beyond the product and

and reach the global community.

ETHICON is our anchor of salvation.

ETHICON has helped us in the last 36 years

through the solidarity initiative Operation Smile.

We cannot go on a mission without them.

They are more than a simple society.

They are our partners.

Our first responsibility is towards doctors,

nurses and patients,

towards mothers and fathers,

and towards all those who use our products and services.

This phrase is not just a phrase of our belief,

of knotless tissue control devices.

devices. Featuring Ethicon's premium needles, patented polymers, extensive code lists, multiple

anchor designs, and plus antibacterial technology for every layer of closure. Now, with over

170 codes, only Ethicon can offer superior wound holding strength, exceptional needle

needle performance, proven PLUS antibacterial technology, and various fixation devices for

ease of use in open, laparoscopic, and robotic procedures.

Rounding out this portfolio is the Stratafix Spiral Knotless Tissue Control Device with

PLUS antibacterial technology.

These unidirectional devices are available in different lengths, sizes, and polymers,

designed for a wide range of surgical procedures in both open and MIP and now

they are being manufactured by Ethicon leveraging our unmatched history of

suture and needle expertise with the most comprehensive and unmatched

portfolio on the market only Ethicon can offer more security more consistency and

more efficiency than traditional sutures for each layer of closure with the added

benefits of Ethicon's well-known and trusted polymers, premium needles, and

proven plus antibacterial technology. It's very nice to have a suture you can

just start suturing and keep moving. You want a suture that's strong when you put

it in and stays strong. Stratafix has the big advantage of you don't have knots so

it's a quicker closure and it makes it so much easier to close those incisions

and it can cut down on the length of time of the procedure significantly. So

suture of the future. So that's what I call it. It's that good. Any case where I can use

Stratafix, that's what I'll do. Only from the worldwide leader in wound closure, Epicon.