Good outcomes after surgery require scrupulous attention to detail: careful patient selection, thorough preoperative evaluation, meticulous surgery and intraoperative anesthesia management, and comprehensive postoperative care. However, numerous perioperative practices based on few or no data—surgical dogma—may do little to help and may even harm patients. For example, routine use of mechanical bowel preparation before colon surgery, nasogastric tubes after gastrointestinal surgery, and antibiotic irrigation of the abdomen remain common practices. Still another example is routine high-dose perioperative glucocorticoid therapy in patients with inflammatory bowel disease.
Nakakura EK. Time to Put Another Surgical Dogma to Sleep?. JAMA Surg. 2014;149(5):466. doi:10.1001/jamasurg.2013.5282