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A Prospective, Randomized Clinical Trial

Bruce G. Wolff, MD; Robert W. Beart, Jr, MD; Roger R. Dozois, MD; John H. Pemberton, MD; Alan R. Zinsmeister, PhD; Roger L. Ready, RN; Michael B. Farnell, MD; John A. Washington, II, MD; Jacques Heppell, MD

Arch Surg. 1988;123(7):895-900.

Abstract
• A two-day cathartic/enema preparation with oral administration of erythromycin and neomycin was compared with an orthograde lavage preparation with oral administration of metronidazole and neomycin in a prospective randomized trial in 300 and 293 eligible patients, respectively, who were undergoing elective colon and rectal surgery. Patients were assessed for infections at six weeks after discharge from the hospital. The major infection rate was less than 1% and the minor infection rate was less than 4%. The overall infection rate was 4.2%. The type of bowel preparation used, the type of operation, and the addition of systemic antibiotic therapy did not affect infection rates significantly. We conclude that this one-day lavage technique, as described, is a safe, effective, economical, and preferred method of colonic preparation for elective colon and rectal surgery.

(Arch Surg 1988;123:895-900)

Author Affiliations
From the Section of Colon and Rectal Surgery (Drs Wolff, Beart, Dozois, Pemberton, and Heppell and Mr Ready), the Department of Health Sciences Research (Dr Zinsmeister), the Section of Gastroenterologic and General Surgery (Dr Farnell), and the Section of Clinical Microbiology (Dr Washington), Mayo Clinic and Mayo Foundation, Rochester, Minn. Dr Washington is now with the Cleveland Clinic Foundation.

Footnotes
Accepted for publication March 23, 1988.

Read before the 95th Annual Meeting of the Western Surgical Association, Dallas, Nov 18, 1987.

Reprint requests to Section of Colon and Rectal Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Wolff).

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