Abstract
This theme issue is devoted to specific aspects of the microbiome that tie to surgically relevant disease. Beginning with a review of microbiome constituents and their contribution to health, we explore how a deranged microbiome may influence conditions that the practicing surgeon would regularly encounter in the clinic, the acute care facility, and in particular, the operating room. Obesity, diabetes mellitus, inflammatory bowel disease, peptic ulcer disease, and reflux esophagitis commonly impact surgical evaluation and decision-making. Certain processes merit focused exploration due to their ubiquity (blood transfusion, septic shock), or their uniqueness (nanomaterial design, pre-habilitation for restoration of gastrointestinal track continuity, malignancy paradigms). Because the operating room and the intensive care unit are the rescue sites within the hospital for critically ill or injured patients, we also explore how critical care management influences the microbiome. Finally, given the continued rise of multi-drug–resistant organisms a foray into non-antibiotic, and perhaps non-microbiome impacting, methods of addressing acute infection seemed ideal. We hope that clinicians will find this issue both informative and inspiring. A wide variety of unanswered questions are raised within these pages, some of which have been previously highlighted within the pages of Surgical Infections. Those questions will ideally lead to novel inquiries into how best to beneficially shape the microbiome to improve outcomes in those who require surgery and perhaps avoid surgery in those whose trajectory may be re-aligned with health.