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Open Access 01-12-2017 | Consensus

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

Authors: Stefan D. Holubar, Traci Hedrick, Ruchir Gupta, John Kellum, Mark Hamilton, Tong J. Gan, Monty G. Mythen, Andrew D. Shaw, Timothy E. Miller, for the Perioperative Quality Initiative (POQI) I Workgroup

Published in: Perioperative Medicine | Issue 1/2017

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).

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Title: 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
Authors: Stefan D. Holubar
Traci Hedrick
Ruchir Gupta
John Kellum
Mark Hamilton
Tong J. Gan
Monty G. Mythen
Andrew D. Shaw
Timothy E. Miller
for the Perioperative Quality Initiative (POQI) I Workgroup
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Perioperative Medicine / Issue 1/2017
Electronic ISSN: 2047-0525
DOI: https://doi.org/10.1186/s13741-017-0059-2

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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

Abstract

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Methods

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