Infection in the surgical patient: an imbalance in the normal equilibrium.

Infection in the surgical patient, like infection elsewhere in the body, is a manifestation of a disturbed host-bacteria equilibrium in favor of the bacteria. It results when bacteria indigenous to that patient achieve dominance over the factors of host resistance. This is reflected by a quantitative increase in the bacterial presence. To be able rationally to prevent and manage such infection requires understanding of how each prophylactic or therapeutic maneuver will work to reestablish the normal equilibrium in the specific situation in which the surgeon finds his patient.