RESUMO
Preoperative mechanical bowel preparation, peroperative topical antiseptic measures, and postoperative antibiotic therapy have all been shown to reduce infection after colorectal surgery. We report the results of a randomised trial of preoperative irrigation with a 10% aqueous solution of povidone-iodine (Betadine) versus water in patients undergoing major resection for large bowel carcinoma. All patients had mechanical bowel preparation, preoperative topical povidone-iodine and per and postoperative antibiotics. Of 22 study patients only one (4.6%) developed abdominal wound infection, whereas in 23 controls nine (39.1%) did so (P less than 0.01). In three of the study patients cultures of swabs taken at operation from the transected bowel ends showed no bacterial growth. Arguably the bacterial population would have been markedly reduced in other patients. These results suggest that povidone-iodine irrigation before large bowel resection reduces wound sepsis.
Assuntos
Neoplasias do Colo/cirurgia , Povidona-Iodo/uso terapêutico , Povidona/análogos & derivados , Pré-Medicação , Neoplasias Retais/cirurgia , Idoso , Bactérias/isolamento & purificação , Feminino , Humanos , Intestinos/microbiologia , Masculino , Povidona-Iodo/administração & dosagem , Infecção da Ferida Cirúrgica/prevenção & controle , Irrigação TerapêuticaRESUMO
Five minutes after transrectal prostatic biopsy 16 out of 21 patients were shown by blood culture to have bacteraemia. Antibiotic prophylaxis--routinely with ampicillin and metronidazole for 48 hours--prevented progression to septicaemia, and four days after the procedure all blood samples were negative. Irrespective of whether antibiotic prophylaxis is used, blood culture should be routine in all patients undergoing transrectal prostatic biopsy.
