[Postoperative management. Critical care in intra-abdominal infection after surgical intervention]

Abstract

UNDERESTIMATED FREQUENCY: Post-operative intraabdominal infections usually appear as abscesses or injury of the bowel, either alone or in combination. These complications of frequently underestimated frequency are characterized by high mortality. Improvement of their prognosis is obtained by early recognition of the complication and a multidisciplinary approach. ALARM SIGNS: In a patient who recently underwent abdominal surgery, the onset of abnormal signs must be considered as an alarm which imposes ruling out intraabdominal complications. Unexplained multiple organ failure or septic shock in the post-operative period of intraabdominal surgery must lead to considering explorative laparotomy.

Therapeutics: Etiologic treatment must be ideal and total from the first reoperation. Antibiotic therapy administered from the surgical reoperation must be different from previous treatments. This treatment is aimed at eradicating enterobacteriaceae, non-fermenting Gram negative aerobes, Gram positive cocci, anaerobes and fungi.