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preoperative mechanical bowel preparation vs antibiotic

Nadeem Anjum, Jianan Ren, Gefei Wang, Guanwei Li, Xiuwen Wu, Hu Dong, Qin Wu, Jieshou Li
BACKGROUND: Preoperative bowel preparation with or without oral antibiotics is controversial in terms of postoperative surgical site infections. OBJECTIVE: This study aimed to evaluate the efficacy of oral antibiotics as adjunct therapy to systemic antibiotics with mechanical bowel preparation for preventing surgical site infections in clean contaminated, contaminated, and dirty colorectal procedures. DESIGN: This was a single-center, prospective randomized study...
December 2017: Diseases of the Colon and Rectum
Kerri A Ohman, Leping Wan, Tracey Guthrie, Bonnie Johnston, Jennifer A Leinicke, Sean C Glasgow, Steven R Hunt, Matthew G Mutch, Paul E Wise, Matthew L Silviera
BACKGROUND: Surgical site infections (SSI) are a common complication after colorectal surgery. An infection prevention bundle (IPB) was implemented to improve outcomes. STUDY DESIGN: A standardized IPB that included the administration of oral antibiotics with a mechanical bowel preparation, preoperative shower with chlorhexidine, hair removal and skin preparation in holding, antibiotic wound irrigation, and a "clean-closure" protocol was implemented in January 2013...
October 2017: Journal of the American College of Surgeons
Ahmet Rencuzogullari, Cigdem Benlice, Michael Valente, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: Elderly patients undergoing colorectal surgery have increasingly become under scrutiny by accounting for the largest fraction of geriatric postoperative deaths and a significant proportion of all postoperative complications, including anastomotic leak. OBJECTIVE: This study aimed to determine predictors of anastomotic leak in elderly patients undergoing colectomy by creating a novel nomogram for simplistic prediction of anastomotic leak risk in a given patient...
May 2017: Diseases of the Colon and Rectum
Michal Mik, Maciej Berut, Radzislaw Trzcinski, Lukasz Dziki, Jaroslaw Buczynski, Adam Dziki
AIM: The objectives were to recognize the risk factors for surgical site infections (SSIs) after surgery due to colorectal cancer and to assess the impact of mechanical bowel preparation (MBP) and oral antibiotic prophylaxis (ABX) on SSIs. METHODS: Records from two colorectal centers were used. Risk factors of SSIs were categorized into patient-, disease-, and treatment-dependent. RESULTS: A group of 2240 patients was included. SSIs were noted in 364 patients (16...
December 2016: Langenbeck's Archives of Surgery
Suleyman Ozdemir, Kamil Gulpinar, S Erpulat Ozis, Zafer Sahli, S Altug Kesikli, Atila Korkmaz, I Ethem Gecim
PURPOSE: The influence of oral antibiotic use together with mechanical bowel preparation (MBP) on surgical site infection (SSI) rate, length of hospital stay and total hospital costs in patients undergoing elective colorectal surgery were evaluated in this study. METHODS: Data from 90 consecutive patients undergoing elective colorectal resection between October 2006 and September 2009 was analyzed retrospectively. All patients received MBP. Patients in group A were given oral antibiotics (a total 480 mg of gentamycin, 4 gr of metronidazole in two divided doses and 2 mg of bisacodyl PO), whereas patients in group B received no oral antibiotics...
September 2016: International Journal of Surgery
John E Scarborough, Christopher R Mantyh, Zhifei Sun, John Migaly
OBJECTIVE: To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS: Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal resection were included for analysis and assigned to 1 of 4 groups based on the type of preoperative preparation they received [combined mechanical and oral antibiotic preparation (OAP), mechanical preparation only, OAP only, or no preoperative bowel preparation]...
August 2015: Annals of Surgery
Elizabeth M Hechenbleikner, Deborah B Hobson, Jennifer L Bennett, Elizabeth C Wick
BACKGROUND: Surgical site infections are a potentially preventable patient harm. Emerging evidence suggests that the implementation of evidence-based process measures for infection reduction is highly variable. OBJECTIVE: The purpose of this work was to develop an auditing tool to assess compliance with infection-related process measures and establish a system for identifying and addressing defects in measure implementation. DESIGN: This was a retrospective cohort study using electronic medical records...
January 2015: Diseases of the Colon and Rectum
Edward K Kim, Kyle H Sheetz, Julie Bonn, Scott DeRoo, Christopher Lee, Isaac Stein, Arya Zarinsefat, Shijie Cai, Darrell A Campbell, Michael J Englesbe
OBJECTIVE: To assess the utility of full bowel preparation with oral nonabsorbable antibiotics in preventing infectious complications after elective colectomy. BACKGROUND: Bowel preparation before elective colectomy remains controversial. We hypothesize that mechanical bowel preparation with nonabsorbable oral antibiotics is associated with a decreased rate of postoperative infectious complications when compared with no bowel preparation. METHODS: Patient and clinical data were obtained from the Michigan Surgical Quality Collaborative-Colectomy Best Practices Project...
February 2014: Annals of Surgery
Yan Liu, Kai-xiong Tao, Guo-bin Wang, Xin Lu, Xiao-hui Li, Yang Huang, Fang Ye
OBJECTIVE: To study the effect of enteral nutrition as replacement of mechanical bowel preparation on peritoneal and intraluminal disseminated tumor cells, recurrence and metastasis in patients with colorectal cancer. METHODS: A total of 120 colorectal cancer patients between March 2007 and December 2011 were enrolled prospectively and randomly divided into two groups. Group A (n=60) received preoperative bowel preparation with enteral nutrition fluid (30 ml·kg(-1)·d(-1)), without enema, taxative or antibiotics...
April 2013: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Jamie A Cannon, Laura K Altom, Rhiannon J Deierhoi, Melanie Morris, Joshua S Richman, Catherine C Vick, Kamal M F Itani, Mary T Hawn
BACKGROUND: Surgical site infection is a major cause of morbidity after colorectal resections. Despite evidence that preoperative oral antibiotics with mechanical bowel preparation reduce surgical site infection rates, the use of oral antibiotics is decreasing. Currently, the administration of oral antibiotics is controversial and considered ineffective without mechanical bowel preparation. OBJECTIVE: The aim of this study is to examine the use of mechanical bowel preparation and oral antibiotics and their relationship to surgical site infection rates in a colorectal Surgical Care Improvement Project cohort...
November 2012: Diseases of the Colon and Rectum
Greta L Krapohl, Laurel R S Phillips, Darrell A Campbell, Samantha Hendren, Mousumi Banerjee, Bonnie Metzger, Arden M Morris
BACKGROUND: Mechanical bowel preparation before colectomy is controversial for several reasons, including a theoretically increased risk of Clostridium difficile infection. OBJECTIVE: The primary aim of this study was to compare the incidence of C difficile infection among patients who underwent mechanical bowel preparation and those who did not. A secondary objective was to assess the association between C difficile infection and the use of oral antibiotics. DESIGN: This was an observational cohort study...
July 2011: Diseases of the Colon and Rectum
Adrian Businger, Gabriela Grunder, Marc-Olivier Guenin, Christoph Ackermann, Ralph Peterli, Markus von Flüe
BACKGROUND: The aim of this study was to assess the use of mechanical bowel preparation (MBP) and antimicrobial prophylaxis in elective colorectal surgery in Switzerland. METHODS: Ninety-eight heads of surgical departments in Switzerland and 42 visceral surgeons in private practice were asked to answer an 18-item questionnaire in October 2008 about arguments in favor of or against MBP. The participants also indicated whether they use MBP and antimicrobial prophylaxis in colorectal surgery, and if so, what agents were used...
January 2011: Langenbeck's Archives of Surgery
Kamal M F Itani, Samuel E Wilson, Samir S Awad, Erin H Jensen, Tyler S Finn, Murray A Abramson
BACKGROUND: The type of mechanical bowel preparation (MBP) used before elective colorectal surgery remains controversial. METHODS: This post hoc analysis of a prospective randomized controlled antibiotic prophylaxis trial (ertapenem vs. cefotetan) evaluated the effect of polyethylene glycol (PEG) and sodium phosphate (SP) MBPs on the rates of postoperative surgical site infections (SSI). RESULTS: Good to excellent MBPs were observed in 281 of 303 (93%) evaluable patients for the PEG and 336 of 367 (92%) for the SP types...
February 2007: American Journal of Surgery
T Y Liou, H Hsu, S S Chen, Y S Feng, H M Wang
The optimal result of colorectal surgery is best achieved by adequate preoperative colon preparation, which should be simple, safe, rapid, and thoroughly clean with little or no discomfort at all for patients. Conventional mechanical preparation, though effective, is time-consuming and unpleasant for patients, therefore new methods have been frequently presented in recent literature to meet the above ideal. A prospective and randomized study was conducted to evaluate preoperative colon preparation in elective, nonobstructive colorectal surgery...
August 1989: Zhonghua Yi Xue za Zhi, Chinese Medical Journal; Free China Ed
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