Lavage Enhances the Production of Proinflammatory Mediators by Peritoneal Mesothelial Cells in an Experimental Model

Abstract

Lavage causes self-limiting peritoneal damage and this is associated with an up-regulation of proinflammatory mediators in animals with peritonitis.

Staged lavage versus single high-volume lavage in the treatment of feculent/purulent peritonitis: a matched pair analysis

“…All patients were treated over a short time period of 8 years with few changes in the surgical staff. Patients treated in the later period, however, were included in a clinical pathway based on four major principals: definitive source control [4][5][6], primary anastomosis or reanastomosis [8,13], large-volume lavage [19], and complete necrosectomy with desiccation of the abdominal cavity to reduce the need for the peritoneal mesothelium to clear contaminated fluid [20,21]. This one step approach reduces the repeated systemic inflammatory challenge in the patient that occurs with planned relaparotomy [22].…”

Comparison of On-Demand vs Planned Relaparotomy Strategy in Patients With Severe Peritonitis

“…27 This reduces the effectiveness of the procedure and the damaging effects of lavage to the mesothelial layer may even reduce the innate resistance to infection. 26,28 In our trial, the on-demand and planned relaparotomy strategies were equally apt to identify patients with remaining or new intra-abdominal infection after the index laparotomy. This also confirms that patients in the planned group were not more frequently determined to show positive findings due to differential verifica- (27) 27 (24) Cardiovascular disease 21 (18) 33 (29) Respiratory disease (chronic obstructive pulmonary disease) 14 (12) 17 (15) Renal disease 10 (9) 7 (6) Diabetes 9 (8) 11 ( …”

Irrigation of peritoneal cavity with cold atmospheric plasma treated solution effectively reduces microbial load in rat acute peritonitis model

“…The decreased TAS in CPL and CPL + Plasma groups is probably due to the consumption of the antioxidants in infection/sepsis. The higher values in the CPL + Saline group compared to the CPL group may be the effect of the impairment of the integrity of the peritoneal mesothelium and the augmentation of proinflammatory mediator response by aggressive irrigation with saline as also shown in Yao et al’s study or a compensating mechanism for depleted antioxidative components as mentioned in Lorente et al study 59 , 60 .…”