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Welcome to the online home of the Vanderbilt General Surgery Residency Handbook. The Handbook is a peer-reviewed, yearly-updated, publicly-available resource.
Emergency general surgery ↵
Outpatient Management: Colostomy¶
- First postoperative visit 7-14 days postoperatively OR two weeks after discharge if hospitalized on postoperative day #14
- Second postoperative visit 2 months postoperatively (telehealth if eligible)
- Pre-Reversal Workup
- If age > 44 and no recent colonoscopy
- Order colonoscopy
- Barium enema if indicated on checklist
- If age < 44 or recent colonoscopy:
- Barium enema if indicated on discharge checklist
- If family history of colon cancer, consider screening colonoscopy prior to reversal
- If known or possible sphincter injury, will need in person appointment with rectal examination
- Anal manometry ordered at faculty discretion
- If manometry abnormal, refer to colorectal surgery
- Schedule date of surgery
- Preoperative Orders
- Antibiotic Bowel Preparation
- Neomycin 1g TID day prior to surgery (2:00 PM, 4:00 PM, 10:00 PM)
- Erythromycin 1g TID is reasonable substitute if neomycin unavailable
- Metronidazole 500 mg TID day prior to surgery (2:00 PM, 4:00 PM, 10:00 PM)
- Neomycin 1g TID day prior to surgery (2:00 PM, 4:00 PM, 10:00 PM)
- Mechanical Bowel Preparation
- Magnesium citrate 1-2 bottles OR
- Miralax (polyethylene glycol) 256 g
- Chlorhexidine Wipes to be used the day before surgery
- NPO 6 hours prior to procedure with electrolyte/sports drink immediately prior to NPO
- Anesthesia: Perioperative Consultation Service consultation for adjunctive analgesia