Prevention of infectious complications after elective colorectal surgery in children: An American Pediatric Surgical Association Outcomes and Clinical Trials Committee comprehensive review

Shawn J. Rangel, Saleem Islam, Shawn D. St. Peter, Adam B. Goldin, Fizan Abdullah, Cynthia D. Downard, Jacqueline M. Saito, Martin L. Blakely, Pramod S. Puligandla, Roshni Dasgupta, Mary Austin, Li Ern Chen, Elizabeth Renaud, Marjorie J. Arca, Casey M. Calkins

Research output: Contribution to journalArticle

Abstract

Objective: This goal of this reviewwas to examine the clinical evidence in support of commonly utilized measures intended to reduce complications following elective colorectal surgery. Data source: Literature searches were performed to identify relevant studies from Medline, PubMed, and Cochrane databases. Study selection: The American Pediatric Surgery Association Outcomes and Clinical Trials Committee selected eight questions to address this topic systematically in the context of three management areas: 1) appropriate utilization of systemic antibiotics for colorectal procedures, 2) reduction of stool burden through mechanical bowel preparation, and 3) intraluminal gut decontamination through use of enteral nonabsorbable antibiotics. Primary outcomes of interest included the occurrence of infectious and mechanical complications related to stool burden and intraluminal bacterial concentration (incisional surgical site infection, anastomotic leakage, and intraabdominal abscess). Results: The evidence in support of each management category was systematically reviewed, graded, and summarized in the context of the review's primary outcomes. Practice recommendations were made as deemed appropriate by the committee. Conclusions: Clinical evidence in support of interventions to reduce infectious complications following colorectal surgery is derived almost exclusively fromthe adult literature. High-quality evidence to guide clinical practice in children is sorely needed, as the available data may have only limited relevance to pediatric colorectal diseases.

Original languageEnglish (US)
Pages (from-to)192-200
Number of pages9
JournalJournal of Pediatric Surgery
Volume50
Issue number1
DOIs
StatePublished - 2015

Keywords

  • Anastomotic leakage
  • Antibiotic prophylaxis
  • Colorectal surgery
  • Deep-space infection
  • Infection control and prevention
  • Intra-abdominal abscess
  • Mechanical bowel preparation
  • Surgical site infection
  • Wound infection

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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    Rangel, S. J., Islam, S., St. Peter, S. D., Goldin, A. B., Abdullah, F., Downard, C. D., Saito, J. M., Blakely, M. L., Puligandla, P. S., Dasgupta, R., Austin, M., Chen, L. E., Renaud, E., Arca, M. J., & Calkins, C. M. (2015). Prevention of infectious complications after elective colorectal surgery in children: An American Pediatric Surgical Association Outcomes and Clinical Trials Committee comprehensive review. Journal of Pediatric Surgery, 50(1), 192-200. https://doi.org/10.1016/j.jpedsurg.2014.11.028