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Open management with mesh and zipper of patients with intra-abdominal abscesses or diffuse peritonitis
1Satakunta Central Hospital, Pori, Finland.
Objective:
To evaluate the open management of intra-abdominal abscesses and persistent peritonitis by the "mesh and zipper" technique, and to assess the predictive value of the APACHE II score.
Design:
Prospective open study.
Subjects:
21 consecutive patients with life-threatening peritonitis.
Interventions:
Insertion of mesh and zipper and lavage once or twice daily with several litres of warmed saline.
Main Outcome Measure:
Mortality.
Results:
Eleven of the 21 patients died (52%). The APACHE II score accurately predicted outcome, in that no patient who scored less than 20 points died, and no patient who scored more than 26 points lived.
Conclusion:
The mesh and zipper technique with daily intraperitoneal lavage is effective in the treatment of life-threatening peritonitis and the APACHE II score is an accurate predictor of survival.