Minimization of Surgical Site Infections for Pts Undergoing Colorectal Surgery

Study Overview
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Brief Summary
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This is a comparison, at this VA Hospital, of standard operating room management in colorectal surgery to a more rigid management using an additional five previously tested treatments to determine if this changes the rate of post operative wound infections.

Detailed Description
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A comparison between standard operating room: use of pre-op bowel prep (Golytely or Phosphosoda,plus 3 doses of oral antibiotics(Erythromycin and Neomycin), and fleets enema the day before surgery Standard anesthesia FiO2 (approx. 30-50%)during surgery Standard IV fluids during surgery(greater than 200cc per hour) Standard post-op O2 by mask for 2 hours To extended operating room procedures of: No po antibiotics or pre-op bowel prep other than enema prior to surgery Skin warming at least 15 minutes prior to and during surgery(core temp 36C+) IOBAN drapes and Plastic wound protectors used during surgery Restricted IV fluids less than 200cc per hour during surgery Increased FiO2 to 80% during surgery and 2 hours after by mask Monitoring for post-op wound infections at discharge and up to 30days post-op

Official Title
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Minimization of Surgical Site Infections for Pts Undergoing Colorectal Surgery

Conditions
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Surgical Wound Infections, Colorectal Surgery

Intervention / Treatment
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* Procedure: standard operating management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Scheduled VA adult elective colorectal surgery patient Exclusion Criteria: Non VA adults, emergent colorectal surgery, scheduled multiple surgery procedures,pts with other infections being treated

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: 1<br>Standard management | |
| Active Comparator: 2<br>Extended management: with no bowel prep except enema,restricted fluids, increased O2,body warming and use of skin protectors during surgery as previously described | Procedure: standard operating management<br>* As previously described<br>* Other names: Extended management;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| %/type Surgical wound infections rated per infection classifications of NNIS/CDC |  | with in 30 days post-op | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| %/type surgical wound infections per classifications per NNIS/CDC |  | at hospital discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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surgery, wound infections, colorectal