Update Course Rewind: Effects of Mechanical Bowel Prep on SSIs 2022

Does mechanical bowel preparation reduce surgical site infections in pediatric colorectal patients? I'm Ellen at Cincinnati Children's and this is one of the questions that Dr. Paul addressed at the 2022 pediatric surgery update course. So here's the case. We have a six-month-old undergoing colostomy closure after a p.sarpe. Which of the following statements about mechanical bowel prep do you think is correct? Uh decreases leaks, decreases hospital stay, promotes early feeding, has no effect on SSI. I mean I think what's fascinating in my career, I read a lot about this, especially adult colorectal surgeons. If you read some of the early papers, it said things like a vigorous mechanical ball preparation as if we're shaking or doing jumping jacks after the thing. In the latest adult surgical literature looking at whether mechanical bowel preparation reduces the rate of surgical site infections, they really haven't seen a benefit of doing mechanical bowel preparation. And this has been seen in multiple studies including a ron review. We know of the strong data, it's appropriate timing of our preoperative intravenous antibiotics. Really no strong data to support any of the other things and some smaller case series on the use of oral antibiotics, flagel, things like that. One thing that has been shown to decrease the rate of surgical site infections in colorectal surgery is pre-operative IV antibiotics 30 minutes before starting the procedure. Additionally, in adult studies, pre-operative oral antibiotics have been associated with reducing surgical site infections. This hasn't really been seen in recent pediatric colorectal retrospective studies, though. Thanks for joining Dr. Yajor Jack and the rest of the Apso Professional Development Committee for this update course rewind. Be sure to check out more pediatric surgical content on the stay current app. Along with Cincinnati Children's, we're sharing knowledge to improve child health around the globe.