New Protocols in Preoperative Bowel Preparation before Major Gynecological Surgeries

Background: It is currently widely acknowledged that several oral or parenteral antibiotics with both aerobic and anaerobic activity, either alone or in combination, along with efficient mechanical preparation, constitute an effective bowel preparation. Numerous antibiotic regimens have been suggested and investigated in clinical settings; some have proven more effective than others. Objective: To find new protocols in preoperative bowel preparation before major gynecological surgeries. Methods: This clinical trial study included 90 patients underwent major gynecological operations in time of the study. The patients in this current study were divided into three groups: Group A: included 30 cases (Neomycin + metronidazole) by oral route. Group B: included 30 cases (Clindamycin + metronidazole) by oral route. Group C: included 30 cases (metronidazole by oral route + Cephalosporins by parenteral route). Results: In our study, mean postoperative length of stay was comparable among our study groups. Bowel injury, sepsis, time to pass stool and death had no significant differences among our study groups. Preoperative discomfort showed significant differences among groups (p < 0.001). Bowel injury, sepsis and death were common among group B (Clindamycin + metronidazole). Our study results found that group C (Cephalosporins + metronidazole) had the highest rate of surgical site infection with statistical insignificant difference. Conclusion: We recommend full bowel preparation, with both oral antibiotics and a mechanical bowel preparation, before the major gynecological surgeries.