Bowel preparation or not for elective colorectal surgery

The importance of bowel preparation in elective colorectal surgery has often been stressed. We have surveyed the current practice of bowel preparation and chemoprophylaxis amongst surgeons in Wales and the south-west of England. From this we identified one surgeon who used no preoperative preparation and his results are reported in detail. One hundred consecutive colorectal cases were studied from one surgeon (J.M.P-T.). There was a 7% incidence of wound infection and one anastomosis leaked. None of these patients had mechanical bowel preparation but all had antibiotic chemoprophylaxis. Mechanical bowel preparation is usual in the UK. These results demonstrate that its importance as a factor in wound infection and anastomotic dehiscence may be overstated.