THE MACHINE age of surgical instrument manufacturing (post-1890) came about partly because of the need for "aseptible" implements. Even though final finishing still entailed much detail work by hand, there was a necessity for simpler instruments that proved more compatible with the dictates of aseptic surgical practices; these instruments were most easily produced by die-forging techniques and stamping presses. The 1-piece alloy steel instrument, devoid of superfluous ornamentation, supplanted the gleaming, highly polished English cast steel instrument fitted into a carefully constructed ebony, ivory, or mother-of-pearl handle. The elegance and quality of surgical implements would henceforth be defined strictly by the functionality and simplicity of design, characteristics paralleling the "new" industrial era virtues of asepsis and machine age production.
Rutkow IM. The American Surgical Instrument Trade in the Aseptic Era. Arch Surg. 1998;133(4):467. doi:10-1001/pubs.Arch Surg.-ISSN-0004-0010-133-4-ssh0498