Continuing search for solutions to trauma associated infections.
The surgeon's unending efforts to control infection in the surgical patient have reopened old avenues in the last years of this century. While there remains much to be learned about ideal antibiotic use, much contemporary energy is devoted to a clarification of the host's non-specific antimicrobial defense system, looking for the salient and critical defect and evaluating putative therapies. The laboratory bench yields a myriad of defects and likely solutions; the clinical scenario has been far less forgiving, and a raft of well-planned and executed clinical trials have produced half an answer. The wisest current strategy in surgical infection control is a judicious critique of failed clinical trials and the prospective development of precise reassessment, seeking a definable valuable outcome. We must continue to monitor the laboratory bench and should apply these concepts to the recalcitrant pneumonia that has been the most common cause of death in surgical patients for the past 30 years.
Polk
H C
HC
Department of Surgery, University of Louisville School of Medicine and the Trauma Program in Surgery, Louisville, Kentucky, USA.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000517:prevention & control*; D017558:Elective Surgical Procedures; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D012128:Respiratory Distress Syndrome / Q000517:prevention & control; D018805:Sepsis / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014946:Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D007371:Interferon-gamma