Donald E Fry1. 1. Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. dfry@consultmpa.com
Abstract
BACKGROUND: Colon preparation for elective colon resection to reduce surgical site infection (SSI) remains controversial. METHODS: A review of the published literature was undertaken to define evidence-based practices for colon preparation for elective colon resection. RESULTS: Seventy years of surgical literature has documented that mechanical bowel preparation alone does not reduce SSI. A body of clinical trials has documented the benefits of oral antibiotic bowel preparation compared with a placebo in the reduction of SSI. Clinical trials show the addition of the oral antibiotic bowel preparation to appropriate systemic preoperative preventive antibiotics provide the lowest rates of SSI. CONCLUSIONS: Mechanical bowel preparation alone does not reduce rates of SSI, but oral antibiotic preparation and systemic preoperative antibiotics are superior when compared with systemic antibiotics alone. Additional clinical trials are necessary to define the best combined overall mechanical and oral antibiotic regimen for elective colon surgery.
BACKGROUND: Colon preparation for elective colon resection to reduce surgical site infection (SSI) remains controversial. METHODS: A review of the published literature was undertaken to define evidence-based practices for colon preparation for elective colon resection. RESULTS: Seventy years of surgical literature has documented that mechanical bowel preparation alone does not reduce SSI. A body of clinical trials has documented the benefits of oral antibiotic bowel preparation compared with a placebo in the reduction of SSI. Clinical trials show the addition of the oral antibiotic bowel preparation to appropriate systemic preoperative preventive antibiotics provide the lowest rates of SSI. CONCLUSIONS: Mechanical bowel preparation alone does not reduce rates of SSI, but oral antibiotic preparation and systemic preoperative antibiotics are superior when compared with systemic antibiotics alone. Additional clinical trials are necessary to define the best combined overall mechanical and oral antibiotic regimen for elective colon surgery.
Authors: Deverick J Anderson; Kelly Podgorny; Sandra I Berríos-Torres; Dale W Bratzler; E Patchen Dellinger; Linda Greene; Ann-Christine Nyquist; Lisa Saiman; Deborah S Yokoe; Lisa L Maragakis; Keith S Kaye Journal: Infect Control Hosp Epidemiol Date: 2014-06 Impact factor: 3.254
Authors: Amos O Adelowo; Michele R Hacker; Anna M Modest; Costa A Apostolis; Anthony J Disciullo; Katherine J Hanaway; Eman E Elkadry; Peter L Rosenblatt; Kathleen J Rogers; Lekha S Hota Journal: Female Pelvic Med Reconstr Surg Date: 2017 Jan/Feb Impact factor: 2.091