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Peritoneal lavage in appendicular peritonitis.

D J Stewart, N A Matheson

    The British Journal of Surgery
    |January 1, 1978
    PubMed
    Summary

    Peritoneal lavage significantly shortens hospital stays for children with appendiceal peritonitis. Antibiotic lavage also reduces septic and adhesive complications, decreasing wound infections and reoperations for sepsis.

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    Area of Science:

    • Pediatric Surgery
    • Infectious Disease Management
    • Abdominal Surgery

    Background:

    • Peritonitis secondary to appendiceal perforation is a common pediatric surgical emergency.
    • Complications such as sepsis and intra-abdominal adhesions can prolong hospital stay and increase morbidity.
    • Optimal management strategies for peritonitis following appendiceal perforation are crucial for improving patient outcomes.

    Purpose of the Study:

    • To evaluate the efficacy of peritoneal lavage in reducing hospital stay duration for children with peritonitis.
    • To compare the incidence of septic and adhesive complications between antibiotic peritoneal lavage, antiseptic lavage, and no lavage.
    • To assess the impact of antibiotic peritoneal lavage on residual intraperitoneal infection and the need for reoperation.

    Main Methods:

    • Retrospective analysis of 189 pediatric patients diagnosed with peritonitis secondary to appendiceal perforation.
    • Comparison of outcomes including hospital stay, septic complications, adhesive complications, wound infections, and reoperations across different lavage groups (antibiotic, antiseptic, none).

    Main Results:

    • Peritoneal lavage significantly reduced the duration of hospital stay.
    • Antibiotic peritoneal lavage led to a significant decrease in septic and adhesive complications compared to antiseptic lavage and no lavage.
    • Fewer wound infections were observed in the antibiotic lavage group, contributing to reduced complications.
    • The incidence of residual intraperitoneal infection was low, with no reoperations for sepsis in the antibiotic lavage group.

    Conclusions:

    • Peritoneal lavage is an effective adjunctive therapy for pediatric peritonitis secondary to appendiceal perforation.
    • Antibiotic peritoneal lavage offers significant benefits in reducing complications and potentially preventing reoperations.
    • Further prospective studies may be warranted to confirm these findings and optimize lavage protocols.

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