Standardized protocol for enterostomy closure Sample Clauses

Standardized protocol for enterostomy closure. (all patients): - Timing of surgery: at least three weeks of MFR or standard treatment and an infant’s body weight of > 2000g - Preoperative contrast study of the distal loop of the enterostomy to rule out stenosis is only necessary if the infants have not reached MFR of the total stool amounts of the preceding 24h. For all other infants preoperative contrast studies can be performed voluntarily. This study may be performed on the NICU by plain abdominal X-ray with enteral contrast (water- soluble isoosmolar) - Central line placement if an adequate amount of calories cannot be provided via a peripheral line. - No preoperative bowel preparation - Placement of nasogastric (NG) tube in the operation room (OR) - Size NG tube: - Premature infants up to 3 months of age: 6F catheter - 3 to 12 months of age: 8F catheter - Small bowel anastomosis: Interrupted sutures with - 5/0 Polyglactin in infants below 6 months of age - 4/0 Polyglactin in infants above 6 months of age - Perioperative antibiotic therapy: type and length based on bacteria profile have to be documented. Suggestion: Perioperative single shot antibiotic treatment. Different antibiotic regimes, adjusted to microbe profiling is possible, but should be documented precisely.
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