Surgical approaches to peritonitis. The value of intra- and postoperative peritoneal lavage

Abstract

Seven hundred seventy-two patients who were presented for surgical treatment because of generalized peritonitis underwent intra- and postoperatively peritoneal lavage by use of a mean of 12 +/- 1 SD and 10 +/- 2 SD litres of warm heparinized normal saline solution respectively. Mean time for intra-operative lavage was 3 +/- 1 SD hours and for post-operative lavage 4 +/- 1 SD days. Peritoneal lavage was combined intra-operatively with mechanical management of any intra-peritoneal viscera perforation and with debridement of any peritoneal or viscus fibrinous exudate. The overall mortality rate was 10.2%, and morbidity 16.2% and the incidence of postoperative intra-peritoneal sepsis 4 patients (0.5%) all of whom underwent re-operation. We believe that the above features have to be considered satisfactory when compared with those reported in the literature. We therefore recommend from the results of this study peritoneal lavage as an effective, safe and simple alternative to the surgical treatment of generalized peritonitis.