Department of Surgery, Division of Acute Care Surgery, Washington University in St. Lous, St. Louis, Missouri, USA.
Department of Surgery, Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Surg Infect (Larchmt). 2023 Apr;24(3):226-231. doi: 10.1089/sur.2023.019.
Several surgically relevant conditions are directly or indirectly influenced by the human microbiome. Different microbiomes may be found within, or along, specific organs and intra-organ variation is common. Such variations include those found along the course of the gastrointestinal tract as well as those on different regions of the skin. A variety of physiologic stressors and care interventions may derange the native microbiome. A deranged microbiome is termed a dysbiome and is characterized by decreased diversity and an increase in the proportion of potentially pathogenic organisms; the elaboration of virulence factors coupled with clinical consequences defines a pathobiome. Specific conditions such as colitis, inflammatory bowel disease, obesity, and diabetes mellitus are tightly linked to a dysbiome or pathobiome. Additionally, massive transfusion after injury appears to derange the gastrointestinal microbiome as well. This review explores what is known about these surgically relevant clinical conditions to chart how non-surgical interventions may support surgical undertakings or potentially reduce the need for operation.
几种与外科手术相关的情况直接或间接地受到人类微生物组的影响。不同的微生物组可能存在于特定器官内部或周围，器官内的变异很常见。这种变异包括胃肠道内的变异以及皮肤不同区域的变异。各种生理应激和护理干预措施可能会扰乱原生微生物组。一个失调的微生物组被称为失调微生物组，其特征是多样性降低，潜在致病生物的比例增加；毒力因子的产生与临床后果相结合定义了病理微生物组。特定疾病，如结肠炎、炎症性肠病、肥胖症和糖尿病，与失调微生物组或病理微生物组密切相关。此外，创伤后大量输血似乎也会扰乱胃肠道微生物组。这篇综述探讨了与外科手术相关的这些临床情况，以阐明非手术干预措施如何支持外科手术或可能减少手术的必要性。
