Journal of Gastrointestinal Surgery

, Volume 17, Issue 12, pp 2172–2178

Selective Decontamination of the Digestive Tract in Gastrointestinal Surgery: Useful in Infection Prevention? A Systematic Review

  • Gabor S. A. Abis
  • Hein B. A. C. Stockmann
  • Marjolein van Egmond
  • Hendrik J. Bonjer
  • Christina M. J. E. Vandenbroucke-Grauls
  • Steven J. Oosterling
Review Article

DOI: 10.1007/s11605-013-2379-y

Cite this article as:
Abis, G.S.A., Stockmann, H.B.A.C., van Egmond, M. et al. J Gastrointest Surg (2013) 17: 2172. doi:10.1007/s11605-013-2379-y

Abstract

Introduction

Gastrointestinal surgery is associated with a high incidence of infectious complications. Selective decontamination of the digestive tract is an antimicrobial prophylaxis regimen that aims to eradicate gastrointestinal carriage of potentially pathogenic microorganisms and represents an adjunct to regular prophylaxis in surgery.

Material and Methods

Relevant studies were identified using bibliographic searches of MEDLINE, EMBASE, and the Cochrane database (period from 1970 to November 1, 2012). Only studies investigating selective decontamination of the digestive tract in gastrointestinal surgery were included.

Results

Two randomized clinical trials and one retrospective case–control trial showed significant benefit in terms of infectious complications and anastomotic leakage in colorectal surgery. Two randomized controlled trials in esophageal surgery and two randomized clinical trials in gastric surgery reported lower levels of infectious complications.

Conclusion

Selective decontamination of the digestive tract reduces infections following esophageal, gastric, and colorectal surgeries and also appears to have beneficial effects on anastomotic leakage in colorectal surgery. We believe these results provide the basis for a large multicenter prospective study to investigate the role of selective decontamination of the digestive tract in colorectal surgery.

Keywords

Antibiotic prophylaxisSurgical wound infection/prevention and controlGastrointestinal tract/surgeryDecontamination

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Gabor S. A. Abis
    • 1
  • Hein B. A. C. Stockmann
    • 2
  • Marjolein van Egmond
    • 1
  • Hendrik J. Bonjer
    • 1
  • Christina M. J. E. Vandenbroucke-Grauls
    • 1
  • Steven J. Oosterling
    • 3
  1. 1.Department of SurgeryVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of SurgeryKennemer Gasthuis Teaching HospitalHaarlemThe Netherlands
  3. 3.Department of SurgeryErasmus Medical CenterRotterdamThe Netherlands