Conclusion Based on the current literature , there is insufficient evidence to indicate that the use of MBP leads to a significant difference in the risk of developing infectious complications in pediatric colorectal surgery
Objectives To evaluate whether the application of mechanical bowel preparation ( MBP ) before colorectal surgery reduces the risk of developing infectious complications in children .
Wound Infection After Elective Colorectal Resection
Introduction : Surgical site infection ( SSI ) is a potentially morbid and costly complication following major colorectal resection . In recent years , there has been growing attention placed on the accurate identification and monitoring of such surgical complications and their costs , measured in terms of increased morbidity to patients and increased financial costs to society . We hypothesize that incisional SSIs following elective colorectal resection are more frequent than is generally reported in the literature , that they can be predicated by measurable perioperative factors , and that they carry substantial morbidity and cost . Methods : Over a 2-year period at a university hospital , data on all elective colorectal resections performed by a single surgeon were retrospectively collected . The outcome of interest was a diagnosis of incisional SSI as defined by the Center of Disease Control and Prevention . Variables associated with infection , as identified in the literature or by experts , were collected and analyzed for their association with incisional SSI development in this patient cohort . Multivariate analysis by stepwise logistic regression was then performed on those variables associated with incisional SSI by univariate analysis to determine their prognostic significance . The incidence of SSI in this study was compared with the rates of incisional SSI in this patient population reported in the literature , predicted by a nationally based system monitoring nosocomial infection , and described in a prospect ively acquired intradepartmental surgical infection data base at our institution . Results : One hundred seventy-six patients undergoing elective colorectal resection were identified for evaluation . The mean patient age was 62 ± 1.2 years , and 54 % were men . Preoperative diagnoses included colorectal cancer ( 57 % ) , inflammatory bowel disease ( 20 % ) , diverticulitis ( 10 % ) , and benign polyp disease ( 5 % ) . SSIs were identified in 45 patients ( 26 % ) . Twenty-two ( 49 % ) SSIs were detected in the outpatient setting following discharge . Of all preoperative and perioperative variables measured , increasing patient body mass index and intraoperative hypotension independently predicted incisional SSI . Although we could not measure statistically increased length of hospital stay associated with SSI , a representative population of patients with SSI accumulated a mean of $ 6200/patient of home health expenses related to wound care . Our rates of SSI were substantially higher than that reported generally in the literature , predicted by the National Nosocomial Infection System , or described by our own institutional surgical infection data base . Conclusions : The incidence of incisional SSI in patients undergoing elective colorectal resection in our cohort was substantially higher than generally reported in the literature , the NNIS or predicted by an institutional surgical infection complication registry . Although some of these differences may be attributable to patient population differences , we believe these discrepancies highlight the potential limitations of systematic outcomes measurement tools which are independent of the primary clinical care team . Accurate surgical complication documentation by the primary clinical team is critical to identify the true frequency and etiology of surgical complications such as incisional SSI , to rationally approach their reduction and decrease their associated costs to patients and the health care system
Conclusion Based on the current literature , there is insufficient evidence to indicate that the use of MBP leads to a significant difference in the risk of developing infectious complications in pediatric colorectal surgery
Objectives To evaluate whether the application of mechanical bowel preparation ( MBP ) before colorectal surgery reduces the risk of developing infectious complications in children .