When I was a little girl, my favorite book was Doctor Dan the Bandage Man, a Little Golden Book. Do you remember it? Dan helps Mother, his sister, even the family dog, when they get cuts and need Band-Aids. I knew I wanted to be a doctor when I grew up, so this book was perfect for me. Best of all, there was a pocket inside the back cover, containing six real Band-Aids! I don’t know how many times I used those Band-Aids and refilled the pocket so I would be ready at a moment’s notice! I wasn’t the only one who loved this book; it sold over 1.75 million copies in its first printing in 1950, and is still in publication. It is also part of the Smithsonian’s permanent collection, where it is recognized as a key piece of American culture.

But where did Band-Aids come from, and what did people use before Band-Aids? People have been hurting themselves, waging war, causing injuries, fighting wild animals, and having accidents since time immemorial. People have always needed bandages.

There are ancient clay tablets and papyruses describing all manner of plasters, which were a combination of liquid and cloth bandages. These plasters contained substances to stop bleeding, absorb secretions, and promote healing. Egyptian papyruses as early as 1600 BC, as well as ancient Chinese texts and Indian writings from the same period all describe closing wounds with sutures, applying honey (which we know has antibacterial properties), stopping bleeding with raw meat, and using clay, mud, plants, herbs, tea in poultices under silk and cloth bandages. They also used grease from animal fat, and lint made from plant fibers, to seal wounds.

The medicinal benefits of raw spider silk have been known for centuries. Ancient Greeks and Romans cleaned wounds with honey and vinegar and then used layers and layers of spider webs to stop the bleeding. Spider webs on wounds continues as a popular folk remedy, even today. You are scoffing at spider webs as a bandage? I’ll have you know that modern science supports this idea; we now know that spider webs can enhance hemostasis (blood clotting). New studies show that some species of spiders secrete an antimicrobial protein coating on their silk fibers. Despite its delicate appearance, spider silk is five times as strong as steel and requires (by weight) more force to break than Kevlar! It is also stretchier than nylon. Perhaps we will see “spidie” Band-Aids in the store soon!

The Greeks recommended washing wounds with clean water, vinegar, and wine. They were experts at complex cloth bandages. Hippocrates, famous Greek physician and surgeon, (c. 460-377 BC), taught students to use vinegar to irrigate open wounds and wrap dressings around wounds to prevent further injury. The famous Greek surgeon Galen (c. 120-210 AD) is mostly known for his writings on anatomy, but he contributed much to wound care. He often cared for gladiators, so he became adept at treating deep wounds. He pioneered suturing deep muscle layers together, ligating severed blood vessels, and dressing wounds with wine-soaked linen and fig leaves.

While adhesive bandages may sound like a modern invention, all these ancient cultures used sticky resins and saps for covering wounds with leaves, papyrus, or cloth.

Early bandages were often simply cotton or linen sheets, clothing, or rags, cleaned, boiled, and cut or torn into strips. Threads from old linen could also be unraveled into frayed and absorbent bandages called “charpie.” Lint, a soft material made by scraping linen cloth, was also a common wound dressing. In fact, after Confederate forces badly defeated the Union Army at the First Battle of Bull Run in 1861, an article in the Boston newspaper read, “To the loyal women and children of the United States: The supply of lint in the market is nearly exhausted. The brave men wounded in defense of their country will soon be in want of it. I appeal to you to come to our aid in supplying us with this necessary article. There is scarcely a woman or child who cannot scrape lint….” Bostonians gathered en masse to make bandages and scrape lint for the army, resulting in a “lint mania,” supplying much more lint than was needed. Families also donated safety pins (just invented 20 years before the war) for holding bandages together.

In 1865, English surgeon Joseph Lister (who had studied Pasteur’s research on germs), began treating his surgical gauze and instruments with carbolic acid and found that his team’s surgical mortality rate plummeted. In 1876, a young man named Robert Wood Johnson attended the Centennial Exposition in Philadelphia. While at the Exposition, he heard the now-famous Dr. Lister give a lecture, championing his radical new idea of antiseptic surgery. Johnson was inspired! He and his two younger brothers went on to found Johnson & Johnson, producing sterilized gauze and wound dressings. When Johnson & Johnson mass-produced the first sterilized, absorbent cotton in thin sheets, it was a breakthrough in surgical care. Good marketers that they were, they developed first aid kits, initially made for railroad workers, who were often injured far away from medical care. These kits, containing sterile gauze, bandages, and dressing, also proved popular with the general public.

Johnson & Johnson’s big innovation came in 1920. Earle Dickson was a J&J cotton buyer. His wife, Josephine, complained of nicks and cuts on her fingers while cooking. It was hard to tie tiny cloth bandages on her own fingers, and those bulky cloth bandages made it hard to prepare food and cook, and hard to wash her hands. Dickson combined adhesive tape and gauze, placing a strip of gauze on a roll of tape with crinoline to prevent the tape from sticking to itself. Josephine loved these new bandages! Dickson eventually showed them to his boss at Johnson & Johnson, and the rest is history.

Actually, Band-Aids, as these new bandages were named, got off to a slow start. They were initially sold in rolls, which customers had to cut to the length they wanted. Then J & J distributed an unlimited number of free Band-Aids to Boy Scouts, and included Band-Aids in first aid kits, which were specifically made for Scouts to use to earn their first aid badge. They also hired traveling salesmen to demonstrate the newfangled product to doctors, retail pharmacists, and butchers (!).

In 1924, mass-produced, pre-cut bandages were introduced, and in 1926, the first metal tins were made. Millions of Band-Aids went overseas to the front lines during World War II, many of them in soldiers’ first aid kits. Band-Aids went to the moon with the Apollo astronauts in 1969. Liquid Band-Aids were developed in 1980s. In 1985, when cosmetics companies were advertising makeup in many shades of brown for different races, J&J countered with clear or “invisible” Band-Aids that were less obvious on all skin tones. In 2021, they finally did come out with OurTone, Band-Aids in a range of shades of brown. In 1997, antibiotic-infused Band-Aids appeared on the market. In 2017, Skin-Flex Band-Aids allowed Band-Aid-wearing people to keep on texting.

Today, there are more than 5,000 wound care products. Most modern dressings contain materials that are highly absorbent, such as alginates, or cellulose. There are occlusive dressings and semi-occlusive dressings. There are growth factors, advanced honey-based dressings, bioengineered tissues, negative pressure wound vacs, transparent dressings, hydrogel and colloid dressings, artificial skin that provides scaffolding to regrow a new layer of skin, and dressings that speed up the clotting process.

Things have come a long way since Doctor Dan the Bandage Man!