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April 1993

Experience With Ambulatory Preoperative Bowel Preparation at The Johns Hopkins Hospital

Author Affiliations

From the Departments of Surgery (Drs Handelsman and Dooley and Mss Coleman and Walrath) and Anesthesiology and Critical Care Medicine (Ms Zeiler), The Johns Hopkins University School of Medicine and Hospital, Baltimore, Md.

Arch Surg. 1993;128(4):441-444. doi:10.1001/archsurg.1993.01420160079013

• A transition to ambulatory preoperative antibiotic bowel preparation was carried out. The protocol included a liquid diet for 40 hours preceding surgery and coordination of purging with buffered oral saline laxative, 45 mL containing 8 g sodium phosphate and 22 g sodium biphosphate (Fleet Phospho-Soda, C. B. Fleet Co, Lynchburg, Va) and bisacodyl preparation with an oral erythromycin base—neomycin routine. Enemas were omitted. Personnel in the preoperative evaluation center had the responsibility of instructing patients, distributing directions and drugs, and reviewing for compliance and possible problems during the preoperative period. All patients scheduled for any of a variety of gastrointestinal procedures, as well as some other complex operations, were included in this study. Follow-up data were obtained. Surgeons' comments regarding efficacy were highly favorable. In only five cases was there comment regarding liquid stool, and this was no impediment to surgery. This incidence was comparable with that of the inpatient experience, as was the spectrum of postoperative complications. Transfer of responsibility to the department proceeded with ease. Results were entirely comparable with those of the former inpatient experience.

(Arch Surg. 1993;128:441-444)

Frazee RC, Roberts J, Symmonds R, Snyder S, Hendricks J, Smith R.  Prospective, randomized trial of inpatient vs. outpatient bowel preparation for elective colorectal surgery . Dis Colon Rectum . 1992;35:223-226.Article
Clarke JS, Condon RE, Bartlett JG, etal.  Preoperative oral antibiotics reduce septic complications of colon operations . Ann Surg . 1977;186:251-258.Article
Boyd MD.  A guide to writing effective patient education materials . Nursing Management . 1987;18:56-57.
Condon RE, Bartlett JG, Greenlee H, et al.  Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations . Arch Surg . 1983;188:496-502.Article
Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP.  The timing of prophylactic administration of antibiotics and the risk of surgical wound infection . N Engl J Med . 1992;326:281-286.Article