Infection control in colon surgery

Abstract

Purpose: The aim of this study is to provide a comprehensive review of strategies that should be employed in the prevention of infection at the surgical site in patients undergoing colon surgery.

Methods: The world's literature on the pathogenesis and prevention of infections at the surgical site in colon resection were reviewed to identify those methods that are associated with improved rates of infection at the surgical site. The pathogenesis, microbiology, diagnosis, and surveillance of surgical site infection have been reviewed in the context of better understanding the accepted methods for prevention. Recommendations are provided based upon evidence-based information when available.

Results: Surgical site infection rates in colon surgery have been reduced consistently over the last 60 years of surgical practice. Preoperative and intraoperative techniques are described which have been useful in this improvement, while postoperative methods including the extension of postoperative systemic antibiotics have not been of value.

Conclusions: Many methods have been demonstrated to improve surgical site infection rates in colon surgery. However, consistent and standardized applications of these principals in prevention currently do not exist. Application of evidence-based practices can further reduce the morbidity and cost of infection following colon surgery.

Keywords: Colon surgery; Mechanical bowel preparation; Oral antibiotic bowel preparation; Preventive antibiotics; Surgical infection control.