Making the fight against surgical infections a truly global concern

Two different subsets of surgical infections deserve our attention worldwide. The first one is about infectious conditions which require surgery in their management process. The second one with special consideration is about the septic complications of surgery. Though all surgeons worldwide now share the concerns of the increasing incidence of injury-related surgical conditions, the challenges of surgical infections are not of the same nature in various regions of the world. A surgeon working in the northern hemisphere will most likely face the difficult problem of nosocomial infections in the context of increasing antibiotics resistance and its estimated 10 million yearly deaths. Meanwhile the surgeon working in the South will often manage peptic ulcer or typhoid fever related bowel perforations (two conditions which are now considered surgical curiosity in the north). To manage these cases, he will likely still use a major open abdominal incision, in the absence of an intensive care unit, without basic imaging tools and laparoscopic facilities. His choice of antibiotics will probably be narrow.

A Global Alliance for the fight against surgical infection is the ideal crucible to bring surgeons from various backgrounds together with the aim of setting universal guidelines for the management and prevention of surgical sepsis. It is likely that while this advocacy will gradually help adjust the level of surgical practice as to offer the same standard of care to all, it will be frequently necessary to provide several sets of standards inspired by the specific working conditions of surgeons worldwide. This would make the fight against surgical infections a truly global concern.

Alain CHICHOM-MEFIRE, Cameroon