The Prophylactic use of Anti-Microbial Agents in the Surgery of the Intestine
The purpose of bowel preparation before surgery is first defined. In order to achieve the objectives of avoiding both tissue sepsis as a result of bacterial invasion from the intestine and interference with healing processes as a result of anti-bacterial therapy it is necessary to reduce the bacterial content of the intestine, and contamination of tissues, without damaging the defence mechanisms of the body.
Mechanical cleansing of the intestine is the first essential process, but may not be possible where partial or complete obstruction is present. Cleansing can be carried out both by reducing the residue of the diet and by washing out the contents of the intestine. Having achieved mechanical cleansing the merits and drawbacks of various anti-bacterial agents are then discussed, both in relation to pre-operative administration of drugs, active within the alimentary canal, and the prophylactic use of antibiotic powders and solutions at the time of operation. Finally, the systemic administration of antibiotics as a prophylactic measure after surgery is discussed.
It is emphasised that surgical technique is of fundamental importance in the prevention of subsequent infective complications.
KeywordsBritish Journal Bowel Preparation Suture Line Povidone Iodine Alimentary Canal
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Aluwihare, A. P. R. (1971). Gut. 12. 341–349PubMedCrossRefGoogle Scholar
Browne, M. K. and Stoller, J, L. (1970). British Journal of Surgery. 57. 525–529PubMedCrossRefGoogle Scholar
Cohn, I. (1964). Maryland Medical Journal. 13. 45–48Google Scholar
Cohn, I. (1970). Surgery, Gynaecology and Obstetrics. 130. 1006–1014.Google Scholar
Crosfil, M., Hall, R. and London, D. (1969). British Journal of Surgery. 56. 906–908CrossRefGoogle Scholar
Drasar, B. S. and Hill, M. J. (1974). Academic Press. London pp. 36–44Google Scholar
Drasar, B. S., Shiner, M. and McLeod, G. M. (1969). Gastroenterology. 56. 71–79PubMedGoogle Scholar
Drasar, B. S. and Shiner, M. (1969). Gut. 10. 812–819PubMedCrossRefGoogle Scholar
Evans, C., and Pollock, A. V. (1973). British Journal of Surgery. 60. 434–437PubMedCrossRefGoogle Scholar
Evans, C., Pollock, A. V. and Rosenberg, I. L. (1974). British Journal of Surgery. 61. 133–135PubMedCrossRefGoogle Scholar
Everitt, M. T., Brogan, T. D. and Nettleton, J. (1969). British Journal of Surgery. 56. 679–684CrossRefGoogle Scholar
Giannella, R. A., Broitman, S. A. and Zamchek, N. (1972). Gut. 13. 251–256PubMedCrossRefGoogle Scholar
Gilmore, O. J. A, and Martin, T. D. M. (1974). British Journal of Surgery. 61. 281–287.PubMedCrossRefGoogle Scholar
Hancock, B. D. (1975). Journal of the Royal College of Surgeons of Edinburgh. 20. 134–137PubMedGoogle Scholar
Hill, M. J., Drasar, B. S., Hawkesworth, G., Crowther, J. S., Aries, V. and Williams, R. E. O. (1971). Lancet 1. 95–100PubMedCrossRefGoogle Scholar
Hill, M. J. and Drasar, B. S. (1975). Gut. 16. 318–323PubMedCrossRefGoogle Scholar
Keighley, M. R. B., Burdon, D. W., Slaney, G., Cooke, W. T. and Alexander-Williams, J. (1975). Gut. 16. 408PubMedCrossRefGoogle Scholar
Leigh, D. A. (1975). British Journal of Surgery. 62. 375–378.PubMedCrossRefGoogle Scholar
Leigh, D. A., Simmons, K. and Norman, E. (1974). Journal of Clinical Pathology. 27. 997–1000PubMedCrossRefGoogle Scholar
McNaught, W. (1975). Personal Communication.Google Scholar
Pickard, R. G. (1972). British Journal of Surgery. 59. 642–648PubMedCrossRefGoogle Scholar
Polk, H. C. and Lopez-Major, J. E. (1969). Surgery. 66. 97–103PubMedGoogle Scholar
Tolhurst Cleaver, C. L., Hopkins, A. D., Kae Kwong, K. C. and Ng Rafteng, A. T. (1974). British Journal of Surgery. 61. 601–604PubMedCrossRefGoogle Scholar
Wambwa, J.R. (1974). East African Journal of Medical Research. 1. 265–272Google Scholar
Willis, A. T. (1974). Lancet. 2. 1540–1543Google Scholar
© Plenum Press, New York 1976