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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.

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Date
2017
Authors
Holubar, Stefan D
Hedrick, Traci
Gupta, Ruchir
Kellum, John
Hamilton, Mark
Gan, Tong J
Mythen, Monty G
Shaw, Andrew D
Miller, Timothy E
Perioperative Quality Initiative (POQI) I Workgroup
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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 article
Subject
Abdominal abscess
Anastomotic 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/10161/13944
Published Version (Please cite this version)
10.1186/s13741-017-0059-2
Publication 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.
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Scholars@Duke

Miller

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.
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    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. 

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