Document Detail


Effect of peritoneal lavage with clindamycin-gentamicin solution on infections after elective colorectal cancer surgery.
MedLine Citation:
PMID:  22265220     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Colorectal surgery may lead to infections because despite meticulous aseptic measures, extravasation of microorganisms from the colon lumen is unavoidable.
STUDY DESIGN: 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:
Jaime Ruiz-Tovar; Jair Santos; Antonio Arroyo; Carolina Llavero; Laura Armañanzas; Alberto López-Delgado; Andres Frangi; Maria Jose Alcaide; Fernando Candela; Rafael Calpena
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  214     ISSN:  1879-1190     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-03-13     Revised Date:  2012-10-16    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  202-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01378832
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / prevention & control*
Aged
Anti-Bacterial Agents / administration & dosage*
Clindamycin / administration & dosage*
Colonic Neoplasms / surgery*
Digestive System Surgical Procedures / adverse effects
Drug Combinations
Female
Gentamicins / administration & dosage*
Humans
Male
Middle Aged
Peritoneal Lavage* / methods
Prospective Studies
Rectal Neoplasms / surgery*
Surgical Procedures, Elective
Surgical Wound Infection / prevention & control*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Drug Combinations; 0/Gentamicins; 18323-44-9/Clindamycin
Comments/Corrections
Comment In:
J Am Coll Surg. 2012 Sep;215(3):445-6   [PMID:  22901520 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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