Effect of Peritoneal Lavage with Clindamycin-Gentamicin Solution on Infections after Elective Colorectal Cancer Surgery

Ruíz-Tóvar, Jaime; Santos, Jair; Arroyo, Antonio; Llavero, Carolina; Armañanzas, Laura; López-Delgado, Alberto; Frangi, Alejandro F.; Alcaide, María José; Candela, Fernando; Calpena, Rafael

doi:10.1016/j.jamcollsurg.2011.10.014

Cited by 44 publications

(38 citation statements)

References 12 publications

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“…In this study, mortality was not reduced in the gentamycine group, however, in some other studies, the mortality was reported to be reduced in the antibiotic irrigation group (9)(10)(11)(12). This difference may be due to the reason that only secondary peritonitis patients were enrolled in this study.…”

Section: Discussioncontrasting

confidence: 56%

“…2017; 22(5):e58188. We did not find any study that evaluated secondary bacterial peritonitis with different etiologies, however, in the Ruiz-Tovar et al study (9), prophylactic peritoneal lavages with and without antibiotics were performed at the end of elective colorectal surgeries and they reported a reduction in superficial as well as deep wound infection and less reoperation due to infection in antibiotic group. The difference between Ruiz-Tovar's results in reducing wound infection and our results may be due to the fact that they made use of gentamycine + clindamycine and we used only gentamycine, however, the need for reoperation due to wound infection was reduced in both studies, which show the benefit of antibiotic lavage at the end of operations (9).…”

mentioning

confidence: 91%

“…Peritoneal lavage is performed in only generalized peritonitis and is not done in localized infections such as perforated appendicitis with a pri-appendicular peritonitis (9). Some studies report that peritoneal lavage with antibiotic solutions after source control in generalized peritonitis has a better outcome, however, there are other studies that report opposite results (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Peritoneal Lavage with Normal Saline and Normal Saline Plus Antibiotic in Acute Peritonitis Patients

Raeeszadeh¹,

Hosseini²,

Khanmohammadi³

et al. 2017

Trauma Mon

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Background: Peritoneal lavage is a need after laparatomies performed for secondary peritonitis. Some previous studies mentioned the benefit of abdominal lavage with antibiotics, in secondary peritonitis operations. The current study aimed to compare normal saline alone (NS) with normal saline plus gentamicin (NS + G) for abdominal lavage in secondary peritonitis. Methods: In this randomized clinical trial (RCT), patients who were referred to the emergency department, and were candidates for urgent laparotomy were enrolled. After giving informed consent, 80 patients were randomized into 2 groups of peritoneal lavage with (NS) and (NS + G). Descriptive statistics were calculated for the presented data. Chi-square test and Fisher's exact test was used for determining the association between qualitative variables. Comparison between the groups was made using the nonparametric Mann-Whitney test. The Kolmogorov-Smirnov test was used for normality of the data. Results: The mean age of the patients was 41.39 years, and 67.5% were male. There were no significant differences in the demographic data, history of abdominal surgery, diabetes, and the cause of peritonitis. Twenty-one patients needed another surgical intervention. The need for surgical interventions was significantly more in the NS group compared to the NS + G group (17.5% vs. 35%, P = 0.039). There was no significant difference in fever, wound infection, admission time, intravenous antibiotic duration, return to work time, and mortality between the 2 groups. Conclusions: It seems that peritoneal lavage with gentamicin in secondary peritonitis may decrease the need for surgical interventions.

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Section: Discussioncontrasting

confidence: 56%

mentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Comparison of Peritoneal Lavage with Normal Saline and Normal Saline Plus Antibiotic in Acute Peritonitis Patients

Raeeszadeh¹,

Hosseini²,

Khanmohammadi³

et al. 2017

Trauma Mon

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“…In a more recent study, Clindamycin-Gentamicin combination lavage was shown to be effective at preventing surgical-site infections of cancerous patients who underwent colorectal resection (18). Another recent retrospective study found that peritoneal irrigation with imipenem solution (1 mg/mL) was more beneficial, compared to irrigation with normal saline, in decreasing the risk of post-operative SSIs (8).…”

Section: Introductionmentioning

confidence: 99%

Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial

Hesami¹,

Alipour²,

Nikoupour³

et al. 2014

Iran Red Crescent Med J

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Background:Perforated appendicitis is one of the most common causes of acute abdomen requiring emergent surgery for immediate appendectomy and peritoneal cavity irrigation; however, the efficacy of irrigation with antibiotic solutions is controversial.Objectives:The aim of this study was to assess the efficacy of imipenem solution irrigation on post-operative surgical site infections (SSIs), hospital length of stay, and hospital costs. We hypothesized that there would be lower rate of SSIs, a shorter hospital stay, and lower hospital cost in patients with perforated appendicitis who received peritoneal cavity irrigation with imipenem solution in comparison to their counterparts who received irrigation with normal saline.Patients and Methods:In this randomized single-blind parallel-group clinical trial, we enrolled 90 patients with perforated appendicitis with 12-50 years of age and randomly allocated them into experimental group (n = 45) and control group (n = 45). The control group received peritoneal irrigation with normal saline (0.9%) and experimental group underwent peritoneal irrigation with imipenem solution (1 mg/mL). All surgical procedures were performed in Imam Reza Hospital of Kermanshah University of Medical Sciences. The study primary outcome was surgical site infections (including wound infection and abdominal abscess) and the secondary outcomes were length of hospital stay and hospital cost. Chi-squared and t-tests were used to analyze the study data.Results:Imipenem solution irrigation was associated with significant clinical improvement at one-month follow-up. The experimental group presented with significantly lower rate of SSIs and shorter length of hospital stay. The experimental group had lower rate of SSIs compared to the control group (4.4% vs. 22.2%, respectively) (p= 0.013). The duration of hospital stay was nearly one day longer in control group (5.84 ± 2.58 days) vs. experimental group (4.91 ± 1.29 days) (P = 0.034), and hospital costs were $50 lower in experimental group ($500 ± $292) vs. control group ($450 ± $170) (P = 0.281).Conclusions:The study findings revealed that peritoneal lavage with imipenem solution (1 mg/mL) decreases the rate of post-operative SSIs in patients with perforated appendicitis in comparison to patients irrigated with normal saline alone. These patients also had shorter hospital stay, and lower hospital costs.

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“…9 The effectiveness of antibacterial irrigation solutions in the surgical field has already been reported in other specialties such as general surgery, orthopedics, and gynecology. [34][35][36] In plastic surgery, there have been several reports on the subject-some authors showed that irrigating the pocket with a povidone-iodine solution [4][5][6][7][8] or local antibiotics 4,9,10 reduced the incidence of CC 8,9 and infections up to 4-fold. [4][5][6][7][8]10 Adams et al 9 prospectively studied 165 cosmetic breast augmentation patients (330 implants) with different surgical techniques, different types of prostheses, and an average follow-up of 14 months (range, 6-75 months).…”

Section: Discussionmentioning

confidence: 99%

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

Giordano¹,

Peltoniemi²,

Lilius³

et al. 2013

Aesthetic Surgery Journal

115

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Effect of Peritoneal Lavage with Clindamycin-Gentamicin Solution on Infections after Elective Colorectal Cancer Surgery

Cited by 44 publications

References 12 publications

Comparison of Peritoneal Lavage with Normal Saline and Normal Saline Plus Antibiotic in Acute Peritonitis Patients

Comparison of Peritoneal Lavage with Normal Saline and Normal Saline Plus Antibiotic in Acute Peritonitis Patients

Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

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