Despite the underfunding of trauma research, useful data are now emerging from trauma centres. The place of the surgeon and his interaction with non‐surgical intensivists is being redefined. Scoring systems and their impact on triage and comparisons between treatment modalities are discussed. Deaths in trauma and surgical patients after the acute phase are frequently linked with sepsis. There are proposals for redefining the terminology in sepsis. The prevalence of colonization and infection in intensive care units (ICUs) is examined together with the place for selective decontamination of the digestive tract (SDD).