• Drew D Howard, Cassandra Q White, Tara R Harden, and C Neal Ellis.
• Department of Surgery, University of South Alabama, Mobile, Alabama, USA. howard@usouthal.edu
• Am Surg. 2009 Aug 1; 75 (8): 659-63; discussion 663-4.

AbstractThis study was performed to determine the incidence of surgical site infections (SSIs) after colorectal resection in patients without mechanical or antibiotic bowel preparation. A retrospective review of the medical records of 136 consecutive patients undergoing an elective colorectal resection between April 2004 and April 2006 was performed. Indications for colon resection in this series were malignant neoplasia (48%), inflammatory bowel disease (18%), diverticular disease (17%), or other benign disease (17%). Overall, an SSI occurred in 31 patients (23%). An SSI occurred in 16 of 90 patients (17.8%) who received antibiotics within 1 hour before surgery and in 15 of 46 patients (33.3%) who did not receive antibiotics in a timely manner (P < 0.05). An SSI occurred in seven of 15 patients (46.7%) who received bowel preparation but in only 24 of 121 patients (19.8%) who did not receive either mechanical or antibiotic bowel preparation (P < 0.029). SSIs were not associated with age, gender, diagnosis, length of procedure, preoperative steroid use, diabetes mellitus, or previous celiotomy. This series shows administration of perioperative antibiotics within 1 hour before surgery is associated with a significant decrease in the incidence of SSI and bowel preparation can be safely omitted.

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