Laparostomy: a technique for the management of severe abdominal sepsis

The mortality from acute suppurative peritonitis may approach 70%, survivors often undergoing multiple operations and requiring protracted intensive medical support. Attempts to improve prognosis fail when they rely on the diagnosis of persistent or recurrent collections. The results of laparostomy in conjunction with continuous peritoneal irrigation (CPI), which aims to primarily eradicate and subsequently prevent the recurrence of sepsis are reported. Two deaths occurred in this series of seven patients, only one attributed to persistent sepsis. Overall, the mortality of 28% compares favourably with similar patient series and suggests that laparostomy with CPI deserves consideration in the management of selected patients with severely contaminated abdominal cavities.