• Login
    View Item 
    •   Home
    • Theses and Dissertations
    • Theses and Dissertations
    • View Item
    •   Home
    • Theses and Dissertations
    • Theses and Dissertations
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of TUScholarShareCommunitiesDateAuthorsTitlesSubjectsGenresThis CollectionDateAuthorsTitlesSubjectsGenres

    My Account

    LoginRegister

    Help

    AboutPoliciesHelp for DepositorsData DepositFAQs

    Statistics

    Display statistics

    Efficacy Of Various Modes Of Bowel Preparation to Prevent Surgical Site Infection Following Elective Colorectal Resection

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    TETDEDXKoller-temple-0225M-122 ...
    Size:
    335.9Kb
    Format:
    PDF
    Download
    Genre
    Thesis/Dissertation
    Date
    2016
    Author
    Koller, Sarah
    Advisor
    Bauer, Katherine W.
    Committee member
    Egleston, Brian
    Esnaola, Nestor F.
    Department
    Clinical Research and Translational Medicine
    Subject
    Surgery
    Medicine
    Bowel Preparation
    Surgical Site Infections
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/3131
    
    Metadata
    Show full item record
    DOI
    http://dx.doi.org/10.34944/dspace/3113
    Abstract
    Purpose: Administration of a mechanical bowel preparation (MBP) has long been standard before colorectal surgery with the aim of preventing complications such as surgical site infection (SSI). Newer evidence suggests that MBP does not reduce the risk of infection and that oral antibiotic (OA) use may be important in reducing post-operative infectious complications, however, there is little evidence comparing MBP, OA, and combination preparations. Our goal was to determine the relationship between type of bowel preparation and SSI in patients undergoing elective colorectal resections Methods: All patients within the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database undergoing elective colorectal resections from 2012 to 2013 were identified. The primary outcomes of interest were: any post-operative SSI, wound SSI, and organ/space SSI. Secondary outcomes were anastomotic leak, post-operative ileus, cardiac complications, renal complications, death, unplanned readmission, and length of stay (LOS). Univariate models were used to compare frequencies of patient and surgical characteristics across types of bowel preparation, and propensity adjustment was used to study the relationship between type of bowel preparation and all outcomes of interest. Results: Among the study sample, 25.5% received no bowel preparation, 40.8% received MBP, 3.3% received OA, and 30.4% received OA+MBP. A total of 1,844 patients (9.5%) developed any type of post-operative SSI. 1,231 (6.4%) developed a wound SSI and 672 (3.5%) developed an organ/space SSI. MBP was not associated with a reduced risk of any type of SSI compared to no bowel preparation. Both OA and OA+MBP were significantly associated with a decreased risk of any SSI and wound SSI compared to both no preparation and compared to MBP. No differences were observed for any SSI or wound SSI between OA and OA+MBP. Compared to no preparation, OA+MBP was associated with a decreased risk of anastomotic leak and post-operative ileus. No differences were observed between MBP and OA, or between these preparation methods and no preparation, for these secondary outcomes. There were no significant associations between type of bowel preparation and cardiac or renal complications, mortality, or readmissions. Both OA and OA+MBP were associated with a reduction in LOS. Conclusion: These results suggest that a combination oral and mechanical bowel preparation may be most effective at preventing SSI after elective colorectal resection and that OA alone may also be effective. Future prospective studies comparing combination and OA preparations may be warranted to explore this relationship further.
    ADA compliance
    For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu
    Collections
    Theses and Dissertations

    entitlement

     
    DSpace software (copyright © 2002 - 2021)  DuraSpace
    Temple University Libraries | 1900 N. 13th Street | Philadelphia, PA 19122
    (215) 204-8212 | scholarshare@temple.edu
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.