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January 1986

Host-Opportunist Interactions in Surgical InfectionPresidential Address

Arch Surg. 1986;121(1):13-22. doi:10.1001/archsurg.1986.01400010019001

The advances in general medical management and surgical care that have been made over the past half century have decreased morbidity in a broad range of surgical patients and have favorably influenced mortality, often in terms of length of survival rather than ultimate salvage. This specific, at times limited, medical progress may only be evident when at-risk groups are appropriately stratified, eg, the increased overall survival of patients with burns of 60% or less of the total body surface as contrasted with the prolongation of hospital stay but unchanged mortality of patients with larger burns1 (Table 1), and the increased immediate survival of patients with mechanical trauma overall as contrasted with the persistent late mortality of severely injured patients after resuscitation.2 The same partial success of initial surgical treatment coupled with intractable late mortality in critically injured and seriously ill patients is evident in transplant recipients and patients

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