Peritoneal Lavage in Abdominal Sepsis

Schein, Moshe; Gecelter, Gary; Freinkel, Wolf; Gerding, Herman; Becker, Piet J.

doi:10.1001/archsurg.1990.01410210058008

Cited by 95 publications

(68 citation statements)

References 13 publications

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“…Schein et al 21 performed a prospective randomised trial of 87 patients undergoing emergency laparotomies for peritonitis. Patients were randomised to receive no IOPL, IOPL with saline or IOPL with chloramphenicol solution.…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that neither IOPL with saline or antibiotics influenced the outcome for these patients in terms of mortality or wound infection rates. 21 Wound infection could be reduced by IOPL but this may also be achieved with instillation of topical antibiotics into the wound. There is no good evidence to show that IOPL with antibiotics is any better than conventional peri-operative intravenous antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Intra-operative peritoneal lavage – who does it and why?

Whiteside

Tytherleigh²,

Thrush³

et al. 2005

Ann R Coll Surg Engl

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INTRODUCTION Intra-operative peritoneal lavage (IOPL) is widely practised but its benefits are unclear. The frequency and pattern of its use amongst general surgeons is investigated.METHODS A postal questionnaire was sent to 153 general surgical consultants and registrars enquiring about their use of IOPL. The surgeon was asked the volume and type of lavage fluid used, under various circumstances.RESULTS 118 (77%) questionnaires were returned. 115 (97%) surgeons used IOPL. The majority of surgeons (61%) lavaged until the fluid was clear, 20% used more than 1 l and 17% used between 500-1000 ml. In the case of the dirty abdomen (i.e. gross pus or faecal peritonitis), 47% used saline as the lavage fluid, 38% aqueous betadine, 9% water and 3% antibiotic lavage. Similar results were found in the case of a contaminated abdomen (i.e. a breached hollow viscus). 34% of surgeons used IOPL during clean cases. 36% used water lavage during intra-abdominal cancer surgery; 21% lavaged with saline and 17% with betadine. More registrars (47%) than consultants (29%) lavaged with water during cancer surgery. Consultants, however, used more aqueous betadine.CONCLUSIONS The frequency of use and choice of lavage fluid varies widely. The successful management of the septic abdomen rests on at least 3 tenants -systemic antibiotics, control of the source of infection and aspiration of gross contaminants. There is little good evidence in the literature to support IOPL in the management of the septic abdomen. The use of IOPL during cancer surgery is supported by in vitro evidence. The current use of IOPL, as shown by this study, appears not to be evidence based.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intra-operative peritoneal lavage – who does it and why?

Whiteside

Tytherleigh²,

Thrush³

et al. 2005

Ann R Coll Surg Engl

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show abstract

“…Mean duration of ambulation was 2.4 with laparoscopic repair and 3.6 with laparotomy. The reason for early ambulation is less postoperative pain in patients with laparoscopic repair as compared to the large abdominal incisions employed in laparotomy [6]. Mean duration of intra abdominal drain in situ in patients with laparoscopic repair was 2.2 days and in patients with laparotomy was 3.8 days.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Versus Open Repair in Management of Peptic Perforation Peritonitis: A Comparative Analysis

Kuswaha¹,

Rabari²,

Bhadania³

2017

IJABMS

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Introduction: Despite the widespread use of antisecretory agents and eradication therapy, the incidence of perforated peptic ulcer has changed little. Since the initial reports of successful laparoscopic management of perforated duodenal ulcers and perforation peritonitis several larger comparative series have been published confirming the technical feasibility and advantages of laparoscopic approach. Objectives:The aim is to compare the outcome and efficacy of laparoscopic repair with conventional laparotomy in the management of peptic perforation. Methods: The study was conducted on patients with diagnosis of peptic perforation in V.S. Hospital, Ahmedabad. It is a retrospective study from August 2014 to November 2016. Result: 50 patients of perforation peritonitis were operated randomly by laparoscopic repair and laparotomy. It was found that the laparoscopic repair of perforated peptic ulcer was associated with less intra operative blood loss, no intraoperative and postoperative complications, minimum postoperative pain which was significant as compared to laparotomy repair. Conclusion: Laparoscopic repair of perforated peptic ulcer could be considered as a good alternative for open repair in routine clinical practice in the management of peptic perforation peritonitis as less intraoperative blood loss, less postoperative pain and better cosmesis.

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“…Intraperitoneal lavage is also a procedure that gener ates PAs, and should only be used when there are clear indications, such as diffuse peritonitis [14], Lavage may damage the peritoneum, either due to the extreme tem perature of the solution used [4,15], alteration in its absorptive functionalism, or extension of the postopera tive ileum. Kappas et al [4,15] reported on the histologi cal changes that occur in the peritoneum subjected to irri gation at different temperatures.…”

Section: Discussionmentioning

confidence: 99%

Influence of Different Aetiological Agents in the Formation of Postoperative Peritoneal Adhesions: Experimental Study in Rats

Egea¹,

Albasini²,

Carmona³

et al. 1993

Dig Surg

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The influence of certain surgical manoeuvres and incidents on the formation of postoperative peritoneal adhesions was analysed in an experimental study on 80 rats. The control group was made up of 10 animals receiving laparotomy and immediate closure. The remaining animals, also laparotomised, were divided into the following groups according to manoeuvre: simple exposure of the abdominal cavity; haemoperitoneum; intraperitoneal lavage; manipulation of the bowel loops, and foreign body. Peritoneal adhesions were quantified 30 days after laparotomy using an original method of the authors. All the groups presented a statistically significant increase in the rate of adhesions with respect to the controls (adhesion rate 3.00 ± 3.29). The increase was more marked in the foreign body (adhesion rate 14.5 ± 1.23), intestinal manipulation (adhesion rate 11.02 ± 1.68), and intraperitoneal lavage (adhesion rate 8.14 ± 1.56) groups.

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Peritoneal Lavage in Abdominal Sepsis

Cited by 95 publications

References 13 publications

Intra-operative peritoneal lavage – who does it and why?

Intra-operative peritoneal lavage – who does it and why?

Laparoscopic Versus Open Repair in Management of Peptic Perforation Peritonitis: A Comparative Analysis

Influence of Different Aetiological Agents in the Formation of Postoperative Peritoneal Adhesions: Experimental Study in Rats

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