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Mon Jan 15 10:05:19 GMT 2007

1. 3 doses of antibiotics, commencing with the first one pre-op.  (Remember
this is for reducing wound infection, not to reduce the incidence of
intra-abdominal abscess).

2. Never leave the skin open (no evidence for any GI surgery) unless you
need to leave the whole abdomen open of course.

Karim

On 14/01/07, Roy Danks <roydanks at hotmail.com> wrote:
>
> skin open for small bowel?  nah.  Don't believe there is any literature
> addressing that.  Colon?  Definately.  Moore in Denver looked at that: very
> beneficial to do delayed skin closure.
>
> RD
>
>
>
> > From: ldresner at gmail.com> Date: Sat, 13 Jan 2007 20:51:49 -0500> To:
> trauma-list at trauma.org> Subject: Re: small bowel injury> > one dose preop.
> none postop- i dont think there is a standard of > care in patients who are
> in shock postop though.> > leave skin open> > lisa d> suny downstate> > On
> Jan 11, 2007, at 10:09 PM, Roy Danks wrote:> > > small bowel? one dose.
> Colon: 24 hrs. I just don't know why, > > with the relative paucity of
> bacteria in the small bowel why more > > than one dose would be needed. If I
> do an elective small bowel > > resection for X disease, I don't give them
> any more than the > > induction antibiotic dose...I guess if you're worried
> about what > > went into the belly with the bullet, that's something else,
> but > > can't remember the last time I saw a staph infection of the belly >
> > after a relatively uncomplicated GSW.> >> >> Date: Thu, 11 Jan 2007
> 14:36:10 -0500> From: jkepros at pol.net> To: > >> trauma-list at trauma.org>
> Subject: Re: small bowel injury> > The > >> EAST guidelines (www.east.org)
> have a pretty clear recommendation > >> of> 24h for that. I believe you are
> correct.> John Kepros MD> > >> Michigan State University> > > Dear List,> >
> I was wondering if > >> you could help settle a friendly discussion I> >
> have with one of > >> my partners...how long to keep antibiotics going> >
> after small > >> bowel injury? I say no more than 24hr. case in point> > 40
> you s/p > >> gsw abdomen, small bowel resection primary anastomosis.> > Any
> > >> literature support would be helpful. Thanks Joe> >> >> > > >>
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