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[Treatment of peritonitis of appendicular etiology]
Abstract:
The authors had 475 patients with appendicular peritonitis under observation. All of them underwent emergency operation and were given antibacterial therapy with metronidazole and agents of the aminoglycoside series. Among 223 patients, the operation on whom was completed by traditional drainage of the abdominal cavity and complete closure of the operative wound, 148 patients developed postoperative complications. Five patients died. In 252 patients, primarily delayed sutures were applied to the wound and drainage of the abdominal cavity was limited. The abdominal cavity was inspected repeatedly in 24 patients with generalized peritonitis and clinical signs of anaerobic nonclostridial infection. Postoperative complications occurred in 87 patients and were limited to suppuration of the wound. One patient died.
Insights
Appendiceal peritonitis surgery outcomes improved with limited drainage and delayed wound closure. This approach reduced complications and mortality compared to traditional methods.
Area of Science:
- Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Appendiceal peritonitis is a severe condition requiring emergency surgical intervention.
- Standard treatment involves abdominal drainage and complete wound closure, often leading to complications.
Observation:
- A study observed 475 patients with appendiceal peritonitis undergoing emergency surgery.
- Patients received antibacterial therapy including metronidazole and aminoglycosides.
Findings:
- Traditional drainage and wound closure in 223 patients resulted in 148 complications and 5 deaths.
- Limited drainage and delayed sutures in 252 patients led to fewer complications (87), primarily wound suppuration, and only 1 death.
Implications:
- Limited abdominal drainage and delayed wound closure appear to be a safer surgical strategy for appendiceal peritonitis.
- This approach may reduce postoperative morbidity and mortality in patients with appendiceal peritonitis.