Perioperative Care

Risk stratification for anticoagulation to determine need for bridging, from Campbell's

Preoperative Evaluation

Labs and Adjunct Testing

Organ-specific evaluation

Specific patient populations

Anticoagulation

Intraoperative management

Avoiding nerve injuries

Antibiotic prophylaxis

Procedure First Choice Antibiotic Alternate Antibiotics Indicated
Catheter removal Fluoroquinolone
TMP/SMX
Aminoglycoside +/- Ampicillin
1st/2nd gen Cephalosporin
Amoxicillin/Clavulanate
If risk factors
Cystoscopy
Urodynamics
Cystography
Cystoscopy + manipulation Always
Transperineal prostate procedure
(Brachytherapy/Cryotherapy)
1st gen Cephalosporin Clindamycin
Transrectal prostate biopsy Fluoroquinolon
2nd/3rd gen Cephalosporin
Aminoglycoside + Metronidazole or Clindamycin
Shock Wave Lithotripsy Fluoroquinolone
TMP/SMX
Aminoglycoside +/- Ampicillin
1st/2nd gen Cephalosporin
Augmentin
Ureteroscopy
Percutaneous renal surgery 1st/2nd gen Cephalosporin
Aminoglycoside + Metranidazole or Clindamycin
Ampicillin/Sulbactam
Fluoroquinolone
Vaginal surgery
Entry into GU tract
Intestinal surgery 2nd/3rd gen Cephalosporin
Aminoglycoside + Metranidazole or Clindamycin
Ampicillin/Sulbactam
Ticarcillin/Clavulanate
Piperacillin/Tazobactam
Fluoroquinolone
Prosthesis implant Aminoglycoside + 1st/2nd gen Cephalosporin or Vancomycin Ampicillin/Sulbactam
Ticarcillin/Clavulanate
Piperacillin/Tazobactam
Abdominopelvic surgery without GU entry 1st gen Cephalosporin Clindamycin If risk factors

Skin

Transfusion

Risk factors to assess need for postoperative VTE prophylaxis, from Campbell's

Postoperative management

VTE prophylaxis

Risk Criteria Recommendation
Low Minor surgery +
Age < 40yo +
No other risk factors
Early ambulation
Moderate Minor surgery + other risk factors
40-60yo without other risk factors
Heparin 5000U TID
Enoxaparin 40mg daily (30mg if CrCL < 30)
High Age > 60yo
40-60yo with other risk factors
Highest Multiple risk factors Enoxaparin 40mg daily (30mg if CrCL < 30) + SCD
Heparin 5000U TID + SCD

Wound care

Pain control options

Sources