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Abstract
In this study which was conducted on 60 patients who underwent
surgery for various colorectal lesions, we compared the use of 3 days
systemic metronidazol and gentamycin versus 3 days oral neomycin-
erythromycin and combination of both oral and systemic regimens in
colorectal surgery besides the use of 3 days preparation with diet oral
bisacodyl, oral magnesium sulphate and saline enema for all patients.
Patients in group A received mettonidazol 500 mg and gentamycin 2mg
per kg. body weight intravenously infusion over half-hour just before
surgery and 2 days after, while patients in group B received 1 grn each of
oral neomycin and erythromycin at 1 P.M, 2P.M and 11 P.M during the
day before operation and 2 days after, while patients in group C received
both oral and systemic antibiotics in the manner previously described.
The over all incidence of septic complications related to colorectal
surgery were 20%, 40% and 20% respectively. The rate of abdominal
wound infection was 10%, 20% and 10% respectively, while the perineal
wound sepsis was 5%, 10% and 5% respectively. Also, the remote
infections were comparably distributed in the three groups. As regard the
postoperative hospital stay it was less in group A than Band C with a
mean of 11,15 and 12 days respectively.
The systemic metronidazol and gentamycin was found to give
better results than the oral neomycin-erythromycin and give equal results
to combination of both oral and systemic as regard the low rate of
infection and the shorter hospital stay.
So, we recommend the use of metronidazol 500mg and gentamycin
2mg per kg. body weight which should be infused over half-hour just
before surgery and 2 days after with mechanical bowel preparation by
diet oral bisacodyl, oral magnesium sulphate and saline enema for 3 days
in colorectal surgery.