title: Effect of peritoneal lavage with clindamycin-gentamicin solution on infections after elective colorectal cancer surgery.
abstract: BACKGROUND
  Colorectal surgery may lead to infections because despite meticulous aseptic measures, extravasation of microorganisms from the colon lumen is unavoidable.
  
  
  METHODS
  A prospective, randomized study was performed between January 2010 and December 2010. Patient inclusion criteria were a diagnosis of colorectal neoplasms and plans to undergo an elective curative operation. Patients were divided into 2 groups: Group 1 (intra-abdominal irrigation with normal saline) and Group 2 (intraperitoneal irrigation with a solution of 240 mg gentamicin and 600 mg clindamycin). The occurrence of wound infections and intra-abdominal abscesses were investigated. After the anastomosis, a microbiologic sample of the peritoneal surface was obtained (sample 1). A second sample was collected after irrigation with normal saline (sample 2). Finally, the peritoneal cavity was irrigated with a gentamicin-clindamycin solution and a third sample was obtained (sample 3).
  
  
  RESULTS
  There were 103 patients analyzed: 51 in Group 1 and 52 in Group 2. There were no significant differences between the groups in age, sex, comorbidities, or type of colorectal surgery performed. Wound infection rates were 14% in Group 1 and 4% in Group 2 (p = 0.009; odds ratio [OR] 4.94; 95% CI 1.27 to 19.19). Intra-abdominal abscess rates were 6% in Group 1 and 0% in Group 2 (p = 0.014; OR 2.14; 95% CI 1.13 to 3.57). The culture of sample 1 was positive in 68% of the cases, sample 2 was positive in 59%, and sample 3 in 4%.
  
  
  CONCLUSIONS
  Antibiotic lavage of the peritoneum is associated with a lower incidence of intra-abdominal abscesses and wound infections.
authors.affiliation: Department of Surgery, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Jair
authors.initials: J
authors.lastname: Santos
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
authors.forename: Laura
authors.initials: L
authors.lastname: Armañanzas
authors.forename: Alberto
authors.initials: A
authors.lastname: López-Delgado
authors.forename: Andres
authors.initials: A
authors.lastname: Frangi
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Alcaide
authors.forename: Fernando
authors.initials: F
authors.lastname: Candela
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
mesh_terms: D018784:Abdominal Abscess / Q000517:prevention & control*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002981:Clindamycin / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004338:Drug Combinations; D017558:Elective Surgical Procedures; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000379:methods; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D005839:Gentamicins; D002981:Clindamycin