Surgical Site Infection
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Surgical Site Infection
Preventing Surgical Site Infection (2024)
Perioperative- A 42-year-old man with a body mass index (BMI) of 34 has stricturing Crohn’s and will need to undergo an ileocecectomy. He smokes a half pack of cigarettes per day. He has previously failed azathioprine and 6-mercaptopurine (6-MP), and he is currently on infliximab and a prednisone taper. What modifiable risk factor would be the most helpful to mitigate to decrease his chances of postoperative infectious complications?
- A 45-year-old man is diagnosed with sigmoid colon cancer on screening colonoscopy. Staging workup shows no evidence of metastatic disease. Which of the following combinations, in addition to standard intravenous antibiotic prophylaxis, is recommended to decrease surgical site infection after segmental colectomy?
- A 75-year-old man with hypertension, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and diabetes is about to undergo an emergent open sigmoid resection for a large bowel obstruction. Which of the following measures has been shown to decrease postoperative surgical site infection (SSI)?
Perioperative- A 56-year-old woman with type 2 diabetes requires an elective sigmoid resection for diverticulitis. Her daily blood glucose is well controlled with metformin and glipizide. To reduce surgical site infection after colectomy, her intraoperative blood glucose level should be:
- A 45-year-old man recently underwent a low anterior resection with coloanal anastomosis for a tumor located 3 cm from the anal verge. In this patient, which preventive measure would be most effective in reducing postoperative septic complication following an anastomotic leak?
- You perform an elective sigmoid resection for diverticulitis in a 53-year-old man. Which medication is most effective in reducing postoperative ileus and length of stay?
General Postoperative Complications- Use of Bowel Preparation in Elective Colon and Rectal Surgery (2019)
Local Excision- Miscellaneous
- Sexually Transmitted Infections of the Colon and Rectum
- Intestinal Stomas
- Pilonidal Disease and Hidradenitis Suppurativa
- Proctectomy for Rectal Cancer
- Preoperative Evaluation in Colorectal Patients
- Abdominal Wall Reconstruction and Parastomal Hernia Repair
- Enhanced Recovery After Colon and Rectal Surgery from ASCRS and SAGES (2023)
- Clostridium difficile Infection
- Anorectal Disease
- A 43-year-old woman underwent a ligation of intersphincteric fistula tract (LIFT) 7 weeks ago to close her posterior transsphincteric anal fistula. She has had persistent discharge from her intersphincteric wound. On clinical examination, she was found to have a persistent internal opening and the external opening has healed. What would be the most appropriate procedure to perform next to resolve her drainage?
- A 52-year-old woman presents with a distal recurrent rectovaginal fistula after 2 failed endorectal advancement flap repairs. She had normal findings on colonoscopy and endorectal ultrasonography confirmed a rectovaginal fistula in the very distal rectum with an intact sphincter complex and seton in place. What is the best next surgical treatment?
- An obese 45-year-old man presents for follow-up after undergoing a bedside incision and drainage of a recurrent left ischiorectal abscess. On examination, you observe a draining left ischiorectal surgical site as well as a right ischiorectal skin punctum that has been draining for several months. What is the most likely underlying cause?
- Preoperative Preparation
- Infectious Colitis
- Fecal Incontinence: Evaluation and Treatment
- Quality
- Presacral Tumors
- Malignancy
- An otherwise healthy 50-year-old patient reports rectal fullness and pain while sitting. On examination, the rectal mucosa is smooth; however, you can palpate a large firm mass that appears extraluminal and extends to the tip of your examining finger. Cross-sectional imaging reveals a large heterogeneous presacral mass that measures 7 cm x 10 cm. The best next step in management is
- A 56-year-old obese man with locally advanced distal rectal cancer is treated with total neoadjuvant chemoradiation therapy. His is a 45-pack-per-year smoker. Restaging reveals no sign of metastasis. Magnetic resonance imaging (MRI) rectal protocol reveals partial clinical response and flexible sigmoidsociopy that shows a 3-cm tumor involving the sphincteric complex. What is the best surgical approach in his care?
- Optimizing Outcomes with Enhanced Recovery
- Benign Disease
- Parastomal and Perineal Hernias
- Anal Cancer
- Colonic Diverticular Disease
- Crohn’s Disease: Surgical Management
- Surgical Management of Crohn's Disease (2020)
- Anorectal Disease
- Treatment of Left-Sided Colonic Diverticulitis (2020)
- Management of Pilonidal Disease (2019)
- Management of Clostridioides difficile Infection (2021)
- Malignancy
- ASCRS Webinars
- Anastomotic Construction
- Gastrointestinal Stromal Tumors, Neuroendocrine Tumors, and Lymphoma
- Pediatric Colorectal Disorders
- Ulcerative Colitis: Surgical Management
- Anastomotic Complications
- Core Descriptor Sets for Rectal Prolapse Outcomes Research Using a Modified Delphi Consensus
- Ostomy Surgery (2022)
- Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula (2022)
- Indications for Fecal Diversion