Management of diffuse peritonitis by prolonged postoperative peritoneal lavage

Area of Science:

• Surgical critical care
• Infectious disease management
• Abdominal surgery

Background:

• Diffuse peritonitis presents a significant mortality risk.
• Managing diffuse peritonitis often requires intensive interventions.
• Identifying effective adjuvant therapies is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of prolonged postoperative peritoneal lavage in patients with diffuse peritonitis.
• To assess the impact of this lavage technique on mortality and intra-abdominal sepsis.
• To determine the safety and effectiveness of antibiotic-infused peritoneal lavage.

Main Methods:

• A cohort of 55 patients with diffuse peritonitis underwent prolonged postoperative peritoneal lavage.
• The technique involved 60-minute cycles of instillation and drainage of lavage fluid.
• Lavage fluid consisted of a hypertonic salt solution with cefotaxime and metronidazole.

Main Results:

• The overall mortality rate was 11% (6/55).
• Only one death was attributed to residual abdominal sepsis post-mortem.
• Five patients experienced further intra-abdominal sepsis, often associated with pre-existing abscesses.

Conclusions:

• Prolonged postoperative peritoneal lavage is associated with an improved outcome in high-risk patients with diffuse peritonitis.
• The technique appears to reduce mortality and the incidence of further intra-abdominal sepsis.
• This method offers a potentially beneficial adjunctive therapy for complex peritonitis cases.