Abstract
The study of intestinal antisepsis has been the concern of the author for the past 40 years. Pioneer studies of sulfanilamide, sulfanilylguanidine, succinylsulfanilamide, succinylsulfathiazole, and phthalylsulfathiazole in dogs are reported, and subsequent clinical trials are detailed. By 1948, intestinal antisepsis had become an established procedure to complement adequate mechanical cleansing. Careful attention to meticulous, gentle handling of tissues, preservation of maximum blood supply, and strict aseptic technique should be continued; intestinal antisepsis is not a substitute for surgical principles. A combination of neomycin-phthalylsulfathiazole, together with the above-named practices, has resulted in an abdominal wall wound infection rate below 3%, with no intra-abdominal complications due to postoperative infection.
Résumé
Depuis 40 ans l'auteur s'est intéressé au problème de l'antisepsie intestinale. Après des études initiales consacrées à l'action de multiples agents médicamenteux chez l'animal il les a employés chez l'homme, les différents essais étant exposés en détail. Dès 1948 la préparation intestinale par les agents antiseptiques est venue s'ajouter en tant que méthode complémentaire à l'évacuation du contenu intestinal. Pour importante que soit la préparation de l'intestin en particulier par les agents antiseptiques elle n'autorise aucune défaillance dans la technique opératoire qui doit être rigoureuse et impose la manipulation atraumatique de l'intestin, le respect méticuleux de la, vascularisation, l'emploi strict de techniques antiseptiques. L'observation de ces préceptes combinée à la préparation de l'intestin à l'aide de ménomycine et de phtalysulfathiazol a permis de réduire l'infection pariétale à un taux inférieur à 3 pour cent et l'infection intrapéritonéale à 0 pour cent.
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Crapp, A.R., Tillotson, P., Powis, S.J.A., Cooke, W.T., Alexander-Williams, J.: Preparation of the bowel by whole-gut irrigation. Lancet2:1239, 1975
Garlock, J.H., Seley, G.P.: The use of sulfanilamide in surgery of the colon and rectum. Preliminary report. Surgery5:787, 1939
Firor, W.M., Jonas, A.F.: The use of sulfanilylguanidine in surgical patients. Ann. Surg.114:19, 1941
Poth, E.J.: A simple mechanical feeding device. J. Lab. Clin. Med.27:931, 1942
Poth, E.J., Knotts, F.L., Lee, J.T., Inui, F.: Bacteriostatic properties of sulfanilamide and some of its derivatives. I. Succinylsulfathiazole, a new chemotherapeutic agent locally active in the gastrointestinal tract. Arch. Surg.44:181, 1942
Poth, E.J., Knotts, F.L.: Succinylsulfathiazole. A new bacteriostatic agent locally active in the gastrointestinal tract. Proc. Soc. Exp. Biol. Med.48:129, 1941
Poth, E.J., McClure, J.N., Jr.: Intestinal obstruction. The protective action of Sulfasuxidine and Sulfathalidine to the ileum following vascular damage. Ann. Surg.131:159, 1950
Cohn, I., Jr.: Intestinal Antisepsis. Springfield, Ill., Charles C Thomas, 1961
Poth, E.J.: Sulfasuxidine and Sulfathalidine. Texas Rep. Biol. Med.4:68, 1946
Poth, E.J., Knotts, F.L.: Clinical use of succinylsulfathiazole. Arch. Surg.44:208, 1942
Poth, E.J., Fromm, S.M., Wise, R.I., Hsiang, C.M.: Neomycin, a new intestinal antiseptic. Texas Rep. Biol. Med.8:353, 1950
Cohn, I., Jr.: Kanamycin for bowel sterilization. Ann. N.Y. Acad. Sci.76:212, 1958
Lockwood, J.S., Young, A.D., Bouchelle, M., Bryant, T.R., Jr., Stojowski, A.J.: Appraisal of oral streptomycin as an intestinal antiseptic, with observations on rapid development of resistance ofE. coli to streptomycin. Ann. Surg.129:14, 1949
Nichols, R.L., Condon, R.E., Gorbach, S.L., Nyhus, L.M.: Efficacy of preoperative antimicrobial preparation of the bowel. Ann. Surg.176:227, 1972
Condon, R.E.: Preparation of the bowel for colon and rectal operations. J. Surg. Pract.8:10, 1979
Rosenberg, I.L., Graham, N.G., deDombal, F.T., Goligher, J.C.: Preparation of the intestine in patients undergoing major large-bowel surgery, mainly for neoplasms of the colon and rectum. Br. J. Surg.58:266, 1971
Clarke, J.S., Condon, R.E., Barlett, J.G., Gorbach, S.L., Nichols, R.L., Ochi, S., Cross, G.H., Gordon, H.E., Greenlee, H., Irvin, G.L., III, Johnson, W.C., Jordan, P.H., Jr., Kaplan, M., Mandiola, S., Schulte, W.J., Storm, F.K., Storz, W.: Preoperative oral antibiotics reduce septic complications of colon operations: Results of prospective, randomized, doubleblind clinical study. Ann. Surg.186:251, 1977
Poth, E.J.: The practical application of intestinal antisepsis to surgery of the colon and rectum. Dis. Colon Rectum6:491, 1960
Poth, E.J., Jacobsen, L.W., Dunlap, W.: Control of tumor transplantation after primary anastomosis of the colon. Surgery49:723, 1961
Poth, E.J.: Intestinal clamps. A new structural principle. Am. J. Surg.61:449, 1943
Poth, E.J., Gold, D.: Intestinal anastomosis. A unique technique. Am. J. Surg.116:643, 1968
Bornside, G.H., Cherry, G.W., Myers, M.B.: Intracolonic oxygen tension andin vivo bactericidal effect of hyperbaric oxygen on rat colonic flora. Aerospace Med.44:1282, 1973
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Poth, E.J. Historical development of intestinal antisepsis. World J. Surg. 6, 153–159 (1982). https://doi.org/10.1007/BF01654682
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DOI: https://doi.org/10.1007/BF01654682