title: Colon preparation and surgical site infection.
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.
authors.affiliation: Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. dfry@consultmpa.com
authors.forename: Donald E
authors.initials: DE
authors.lastname: Fry
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019072:Antibiotic Prophylaxis / Q000009:adverse effects / Q000379:methods; D002400:Cathartics / Q000008:administration & dosage* / Q000266:history; D002986:Clinical Trials as Topic; D003082:Colectomy; D003106:Colon / Q000187:drug effects / Q000382:microbiology*; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D004917:Erythromycin / Q000008:administration & dosage; D019317:Evidence-Based Medicine; D049673:History, 20th Century; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D016017:Odds Ratio; D010710:Phosphates / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002400:Cathartics; D010710:Phosphates; D008795:Metronidazole; D011092:Polyethylene Glycols; D004917:Erythromycin; C018279:sodium phosphate