Minimization of Surgical Site Infections for Pts Undergoing Colorectal Surgery

Colorectal Surgery, Surgical Wound Infections

surgery, wound infections, colorectal

This is a comparison, at this VA Hospital, of standard operating room management in colorectal surgery to a more rigid management using an additional five previously tested treatments to determine if this changes the rate of post operative wound infections.

A comparison between standard operating room: 1. use of pre-op bowel prep (Golytely or Phosphosoda,plus 3 doses of oral antibiotics(Erythromycin and Neomycin), and fleets enema the day before surgery 2. Standard anesthesia FiO2 (approx. 30-50%)during surgery 3. Standard IV fluids during surgery(greater than 200cc per hour) 4. Standard post-op O2 by mask for 2 hours To extended operating room procedures of: 1. No po antibiotics or pre-op bowel prep other than enema prior to surgery 2. Skin warming at least 15 minutes prior to and during surgery(core temp 36C+) 3. IOBAN drapes and Plastic wound protectors used during surgery 4. Restricted IV fluids less than 200cc per hour during surgery 5. Increased FiO2 to 80% during surgery and 2 hours after by mask Monitoring for post-op wound infections at discharge and up to 30days post-op

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