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Related Experiment Videos

Scheduled reoperations (etappenlavage) for diffuse peritonitis.

W Teichmann, D H Wittmann, P A Andreone

    Archives of Surgery (Chicago, Ill. : 1960)
    |February 1, 1986
    PubMed
    Summary
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    Etappenlavage, a surgical technique involving repeated abdominal lavage, effectively manages diffuse peritonitis. This approach reduces mortality in high-risk patients by controlling infection and promoting healing.

    Area of Science:

    • Surgical Innovation
    • Critical Care Medicine
    • Abdominal Surgery

    Background:

    • Diffuse peritonitis presents a significant challenge in critical care.
    • High-risk patients often develop multiple system organ failure.
    • Early management strategies are crucial for improving outcomes.

    Purpose of the Study:

    • To evaluate the efficacy of etappenlavage for treating diffuse peritonitis.
    • To assess the impact of etappenlavage on mortality in high-risk surgical patients.
    • To determine the role of scheduled reoperations in managing intra-abdominal sepsis.

    Main Methods:

    • Etappenlavage, a staged laparotomy with abdominal lavage, was employed.
    • High-risk patients were routinely reexplored daily until clinical improvement.

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  • Patient data from 1980-1984 included 61 patients with intra-abdominal sepsis.

    • Main Results:

    • A total of 235 etappenlavages were performed (mean 3.9 per patient).
    • Primary wound healing occurred in 79% of cases after definitive closure.
    • The overall mortality rate in this high-risk group was 22.9%.

    Conclusions:

    • Etappenlavage is a viable strategy for managing diffuse peritonitis.
    • The technique aids in source control, material elimination, and complication recognition.
    • Scheduled reoperations can improve outcomes in severe intra-abdominal infections.