In Patients Undergoing Colorectal Resection, Can Preoperative Antibiotics Combined With Mechanical Bowel Preparation Compared With Mechanical Bowel Preparation Only Significantly Reduce Surgical Site Infection?

ObjectiveTo assess the relative contribution of intravenous antibiotic prophylaxis, mechanical bowel preparation, oral antibiotic prophylaxis, and combinations thereof towards the reduction of surgical site infection (SSI) incidence in elective colorectal resections.Methods and analysisA systematic search of randomised controlled trials comparing interventions to reduce SSI incidence will be conducted with predefined search terms in the following databases: MEDLINE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR). Additionally, several online databases will be searched for ongoing trials, and conference proceedings and reference lists of retrieved articles will be hand searched. The title–abstract screening will be partly performed by means of a semiautomated supervised machine learning approach, which will be trained on a subset of the identified titles and abstracts identified through traditional screening methods.The primary analysis will be a multicomponent network meta-analysis, as we expect to identify studies that investigate combinations of interventions (eg, mechanical bowel preparation combined with oral antibiotics) as well as studies that focus on individual components (mechanical bowel preparation or oral antibiotics). By means of a multicomponent network meta-analysis, we aim at estimating the effects of the separate components along the effects of the observed combinations. To account for between-trial heterogeneity, a random-effect approach will be combined with inverse variance weighting for estimation of the treatment effects. Associated 95% CIs will be calculated as well as the ranking for each component in the network using P scores. Results will be visualised by network graphics and forest plots of the overall pairwise effect estimates. Comparison-adjusted funnel plots will be used to assess publication bias.Ethics and disseminationEthical approval by the Ethical Committee of the Medical Faculty of the Martin-Luther-University Halle-Wittenberg (ID of approval: 2021–148). Results shall be disseminated directly to decision-makers (eg, surgeons, gastroenterologists, wound care specialists) by means of publication in peer-reviewed journals, presentation at conferences and through the media (eg, radio, TV, etc).PROSPERO registration numberCRD42021267322.

Download Full-text

Can mechanical bowel preparation with oral antibiotics reduce surgical site infection and anastomotic leakage rates following elective colorectal resections?

Formosan Journal of Surgery ◽

10.4103/fjs.fjs_55_17 ◽

2018 ◽

Vol 51 (1) ◽

pp. 21

Author(s):

Chien-Kuo Liu ◽

Wen-Chun Sun ◽

Hsi-Hsien Hsu ◽

Hao-Che Liu

Keyword(s):

Surgical Site Infection ◽

Anastomotic Leakage ◽

Bowel Preparation ◽

Mechanical Bowel Preparation ◽

Site Infection ◽

Oral Antibiotics ◽

Colorectal Resections

Download Full-text

The Prevention of Surgical Site Infection in Elective Colon Surgery

Scientifica ◽

10.1155/2013/896297 ◽

2013 ◽

Vol 2013 ◽

pp. 1-19 ◽

Cited By ~ 9

Author(s):

Donald E. Fry

Keyword(s):

Surgical Site Infection ◽

Bowel Preparation ◽

Mechanical Bowel Preparation ◽

Local Environment ◽

Colon Surgery ◽

Colon Resection ◽

Oral Antibiotic ◽

Site Infection ◽

Elective Colon Surgery ◽

Elective Colon

Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes.

Download Full-text