[size=20px]A six-month old is undergoing colostomy closure after a posterior sagittal anorectoplasty.

 

Which of the following statements regarding mechanical bowel preparation is correct?

 

A decreases the risk of anastomotic leak

 

B decreases length of hospital stay

 

C promotes early feeding post-operatively

 

D has no effect on surgical site infections (SSI)

 

E must be done as an inpatient[/size]

A

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A

Think again my dear

Sorry prof, but not correct according to the model answer

correct answer

D has no effect on surgical site infections (SSI)

 

Preoperative mechanical bowel preparation for colonic surgery has been highly utilized in an attempt to decrease surgical site infections. There is little to no compelling evidence in the adult or pediatric literature to support this. In recent adult studies, including a Cochrane review, there is no benefit from mechanical bowel preparation in reducing surgical site infections (SSI). In fact, some studies report an increase in wound infections following mechanical bowel preparation.

 

Case appropriate preoperative intravenous (IV) antibiotics given within 30 minutes before the start of the procedure have been shown to lessen SSI. Recent adult studies also suggest the important benefit of preoperative oral antibiotics in addition to IV antibiotics in decreasing postoperative SSI. However, the importance of oral antibiotics in pediatric colon operations has not been born out in several recent retrospective studies. Malnutrition is a well established risk factor for colostomy SSI in adult studies but is less well established as a factor in children.

D - no effect in SSI

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D