The influence of intestinal microbiome on wound healing and infection

Wound healing problems and surgical site infections are commonly attributed to improper intraoperative technique and perioperative infection control methods. However, overwhelming evidence is emerging to suggest that the intestinal microbiome plays a profound and previously underappreciated role in infectious outcomes of surgery. Surgical stress and perioperative medical interventions alter the community structure and function of the intestinal microbiome. The resultant intestinal dysbiosis exerts overarching effects on the host immune and neuroendocrine systems. Although certainly infection is known to occur from inadvertent intraoperative contamination, a more intriguing concept is the possibility that alterations in the intestinal microbiome, occurring in response to the physiologic stress of surgery, may have a major negative influence on the host's ability for tissue repair, regeneration, and resilience to infection.