American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery.
Abstract
BACKGROUND: Colorectal surgery (CRS) patients are an at-risk population who are particularly
vulnerable to postoperative infectious complications. Infectious complications range
from minor infections including simple cystitis and superficial wound infections to
life-threatening situations such as lobar pneumonia or anastomotic leak with fecal
peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches
that can be used to reduce the risk of postoperative infections. METHODS: With input
from a multidisciplinary, international group of experts and through a focused (non-systematic)
review of the literature, and use of a modified Delphi method, we achieved consensus
surrounding the topic of prevention of postoperative infection in the perioperative
period for CRS patients. DISCUSSION: As a part of the first Perioperative Quality
Initiative (POQI-1) workgroup meeting, we sought to develop a consensus statement
describing a comprehensive, yet practical, approach for reducing postoperative infections,
specifically for CRS within an ERP. Surgical site infection (SSI) is the most common
postoperative infection. To reduce SSI, we recommend routine use of a combined isosmotic
mechanical bowel preparation with oral antibiotics before elective CRS and that infection
prevention strategies (also called bundles) be routinely implemented as part of colorectal
ERPs. We recommend against routine use of abdominal drains. We also give consensus
guidelines for reducing pneumonia, urinary tract infection, and central line-associated
bloodstream infection (CLABSI).
Type
Journal articleSubject
Abdominal abscessAnastomotic leak
Carepath
Catheter or line-associated bloodstream infection
Colorectal surgery
Enhanced recovery
Enhanced recovery pathway
Enhanced recovery protocol
Infection prevention
Mechanical bowel preparation
Pelvic abscess
Pneumonia
Surgical site infection
Urinary tract infection
Permalink
https://hdl.handle.net/10161/13944Published Version (Please cite this version)
10.1186/s13741-017-0059-2Publication Info
Holubar, Stefan D; Hedrick, Traci; Gupta, Ruchir; Kellum, John; Hamilton, Mark; Gan,
Tong J; ... Perioperative Quality Initiative (POQI) I Workgroup (2017). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative
(POQI) joint consensus statement on prevention of postoperative infection within an
enhanced recovery pathway for elective colorectal surgery. Perioper Med (Lond), 6. pp. 4. 10.1186/s13741-017-0059-2. Retrieved from https://hdl.handle.net/10161/13944.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Timothy Ellis Miller
Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine;
with particular interests in fluid management, and perioperative optimization of the
high-risk non-cardiac surgery patient.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info
Related items
Showing items related by title, author, creator, and subject.
-
American Society for Enhanced Recovery: Advancing Enhanced Recovery and Perioperative Medicine.
Gan, Tong J; Scott, Michael; Thacker, Julie; Hedrick, Traci; Thiele, Robert H; Miller, Timothy E (Anesthesia and analgesia, 2018-06)As the population ages, the increasing surgical volume and complexity of care are expected to place additional care delivery burdens in the perioperative setting. In this age of integrated multidisciplinary care of the surgical ... -
Correction to: American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2-From PACU to the Transition Home.
Scott, Michael J; McEvoy, Matthew D; Gordon, Debra B; Grant, Stuart A; Thacker, Julie KM; Wu, Christopher L; Gan, Tong J; ... (11 authors) (Perioperative medicine (London, England), 2018-01)[This corrects the article DOI: 10.1186/s13741-017-0063-6.]. -
Correction to: American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.
Thiele, Robert H; Raghunathan, Karthik; Brudney, CS; Lobo, Dileep N; Martin, Daniel; Senagore, Anthony; Cannesson, Maxime; ... (12 authors) (Perioperative medicine (London, England), 2018-01)[This corrects the article DOI: 10.1186/s13741-016-0049-9.].