Targeting the Perioperative Microbiome: Emerging Strategies to Reduce Post-Surgical Infections
DOI:
https://doi.org/10.64229/jrbhk155Keywords:
Perioperative microbiome modulation, Surgical site infection, Probiotics, Predictive biomarkers, Precision surgeryAbstract
Background: Despite major advances in aseptic techniques and antibiotic prophylaxis, surgical site infections (SSIs) remain a leading cause of postoperative morbidity and a significant contributor to global healthcare burden. Increasing evidence indicates that the perioperative microbiome encompassing gut, skin, and mucosal microbial communities play a critical role in immune regulation, wound healing, and host defense. Perioperative disruptions to microbial homeostasis can induce dysbiosis, impair epithelial barrier integrity, and amplify inflammatory responses, thereby increasing susceptibility to infection. Targeted modulation of this microbial interface represents an emerging frontier in precision surgical care. Methods: A systematic evidence-based review of peer-reviewed literature published between 2020 and 2025 was conducted using PubMed, Scopus, the Cochrane Library and Web of Science. Eligible studies included clinical trials, translational investigations, and in vivo models evaluating microbiome-targeted interventions, predictive microbial biomarkers, or artificial intelligence (AI)_based surgical site infection (SSI) risk modeling. Data extraction focused on intervention type, study design, microbiome outcomes, immune markers, and infection rates. Results: Microbiome-directed strategies including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) were associated with enhanced mucosal integrity, reduced pathogenic colonization, and modulation of inflammatory pathways. Adjunctive approaches such as photobiomodulation therapy and probiotic-coated dressings demonstrated synergistic benefits. AI-driven microbiome analytics enabled personalized SSI risk prediction through microbial profiling. Conclusion: Microbiome-informed perioperative care offers a paradigm shift toward personalized, antimicrobial-sparing SSI prevention. Future translation requires standardized protocols, validated predictive models, and integration of AI-assisted clinical decision-support systems.
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Copyright (c) 2026 Badariyya Abdullahi (Author)
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