title: Current practices of preoperative bowel preparation among North American colorectal surgeons.
abstract: In North America, the rate of infections following colorectal surgery decreased after the introduction of oral antibiotic bowel preparation against colonic microflora. Eight hundred eight board-certified colorectal surgeons were surveyed for their current bowel preparation practices before elective procedures. The 471 responders (58%) all use mechanical preparation: oral polyethylene glycol solution (70.9% of the respondents), oral sodium phosphate solution with or without bisacodyl (28.4%), and "traditional" methods of dietary restriction, cathartics, and enemas (28.4%). Most surgeons (86.5%) add oral and parenteral antibiotics to the regimen; 11.5% add only parenteral antibiotics, 1.1% add only oral antibiotics, and 0.9% add no antibiotics. Generally (77.8% of cases), oral neomycin and erythromycin or metronidazole are combined with a perioperative parenteral antibiotic. Most individuals start the preparation as outpatients the day before surgery, and the parenteral drugs are added to the regimen 1-2 hours before the procedure. The use of outpatient bowel preparation is increasing; however, patient selection is critical, and education is needed to reduce the rate of complications.
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Nichols
authors.forename: J W
authors.initials: JW
authors.lastname: Smith
authors.forename: R Y
authors.initials: RY
authors.lastname: Garcia
authors.forename: R S
authors.initials: RS
authors.lastname: Waterman
authors.forename: J W
authors.initials: JW
authors.lastname: Holmes
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003106:Colon / Q000601:surgery*; D003107:Colorectal Surgery; D019538:Health Care Surveys; D006801:Humans; D009656:North America; D011300:Preoperative Care; D012007:Rectum / Q000601:surgery*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents