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Related Experiment Videos

Open versus closed diagnostic peritoneal lavage. A multiphasic prospective randomized comparison.

W Cochran, W S Sobat

    Annals of Surgery
    |July 1, 1984
    PubMed
    Summary

    Open versus closed peritoneal lavage showed similar accuracy in trauma patients. However, the supraumbilical approach is superior for pelvic fractures, while the infraumbilical approach should be avoided.

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    Area of Science:

    • Trauma Surgery
    • Surgical Techniques
    • Diagnostic Procedures

    Background:

    • Peritoneal lavage is a diagnostic tool used in trauma patients.
    • The choice between open and closed techniques, and the approach (infraumbilical vs. supraumbilical) for pelvic fractures, may impact diagnostic accuracy.

    Purpose of the Study:

    • To compare the diagnostic accuracy of open versus closed peritoneal lavage in trauma patients.
    • To evaluate the efficacy of infraumbilical versus supraumbilical approaches for peritoneal lavage in patients with pelvic fractures.

    Main Methods:

    • Prospective randomized study involving 118 trauma patients.
    • Patients were assigned to either open or closed peritoneal lavage.
    • A subgroup analysis compared infraumbilical and supraumbilical approaches in patients with pelvic fractures.

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    Main Results:

    • No statistically significant difference in accuracy between open (96.6%) and closed peritoneal lavage.
    • The supraumbilical approach demonstrated significantly higher accuracy (90.9%) compared to the infraumbilical approach (57%) in patients with pelvic fractures.
    • Factors such as patient body habitus, technique, and physician experience influence lavage outcomes.

    Conclusions:

    • Both open and closed peritoneal lavage techniques are accurate for diagnosing intra-abdominal injuries in trauma patients.
    • The supraumbilical approach is recommended for peritoneal lavage in patients with pelvic fractures due to its superior accuracy.
    • The infraumbilical approach is strongly discouraged for patients with pelvic fractures.