[Mechanical and antibiotic preparation and infections in colorectal surgery. Comparison of 2 methods of orthograde lavage].
The efficacy of two methods of orthograde lavage preparation in elective colorectal surgery was tested in 133 consecutive patients: the results obtained with whole gut irrigation (50 patients, group A) were compared with the results of oral lavage solution (83 patients, group B). All patients received a parenteral association of antibodies (clindamycin in combination with a broad spectrum antibiotic, mainly II or III generation cephalosporins). Bacterial cultures were carried out at the end of the lavage in the rectal effluent (no statistically significant differences between the two groups) and in the intraoperative aspirate from the colon (the bacterial concentration was higher in group B). The total number of infections was 12 (9%), with 6 (12%) in group A and 6 (7.2%) in group B. The infectious complications involved perineal wound in 9 cases (in 2 patients in combination with abdominal wound infection), abdominal drainage in 2 and abdominal wound in 1. The type of broad spectrum antibiotic did not affect the infection rate significantly. Perioperative and infection site bacteriological cultures grew the same type of organism only in one case. The surgeons' judgement of the adequacy of the cleansing favored whole gut irrigation, although the results of the study revealed that both methods were safe and provided equally adequate bowel cleansing.
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Chirurgia Generale II, Università degli Studi di Cagliari.
Deriu
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D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001398:Aztreonam / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003082:Colectomy; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D012007:Rectum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000379:methods*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002981:Clindamycin; D001398:Aztreonam
Preparazione meccanico-antibiotica e infezioni in chirurgia colorettale. Confronto tra due metodi di lavaggio ortogrado.