title: A multicenter evaluation of the role of mechanical bowel preparation in pediatric colostomy takedown.
abstract: BACKGROUND
  In response to studies in adults that have failed to demonstrate a benefit for mechanical bowel preparation in colonic surgery, we sought to evaluate the utility of mechanical bowel preparation in a multicenter, retrospective study of children who underwent colostomy takedown.
  
  
  METHODS
  The records of 272 children who underwent colostomy takedown at 3 large children's hospitals were reviewed, and the utilization of mechanical bowel preparation and perioperative antibiotics was noted. Length of stay and the incidences of wound, anastomotic, and other complications were compared.
  
  
  RESULTS
  A polyethylene glycol bowel prep was administered to 187 children. All subjects received perioperative, intravenous antibiotics, and 52% of those with bowel preps received preoperative oral antibiotics. Subjects in the bowel prep group had a significantly higher incidence of wound infection (P = .04) and longer length of stay (P = .05). Oral antibiotics did not affect outcome.
  
  
  CONCLUSIONS
  The use of a mechanical bowel preparation in children before colostomy takedown was associated with a greater risk for wound infection, no protection from other complications, and a longer length of stay. This suggests that bowel preparation may be safely omitted in many children who undergo colonic surgery, thereby reducing cost and discomfort.
authors.affiliation: Division of Pediatric Surgery, Loma Linda University School of Medicine and Children's Hospital, Loma Linda, CA 92354, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Serrurier
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.forename: Francine
authors.initials: F
authors.lastname: Breckler
authors.forename: Nini
authors.initials: N
authors.lastname: Khozeimeh
authors.forename: Deborah
authors.initials: D
authors.lastname: Billmire
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gingalewski
authors.forename: Gerald
authors.initials: G
authors.lastname: Gollin
mesh_terms: D002648:Child; D002675:Child, Preschool; D003125:Colostomy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011300:Preoperative Care / Q000009:adverse effects*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D011092:Polyethylene Glycols