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Laparostomy for the Surgical Treatment of Diffuse Peritonitis

  • W. Barthlen
  • H. Bartels
  • M. Hölscher
Conference paper

Abstract

The therapeutical concept of programmed relaparotomy, as applied at our institution in the treatment of diffuse peritonitis, procedurally does not permit leaving the abdomen unclosed. Instead, following removal or elimination of the infectious source (focus sanitation) and meticulous debridement of the abdominal cavity with lavage, the abdominal wall is primarily closed without drainage. This procedure is repeated at fixed 48-h intervals until the peritonitis subsides. A final “control relaparotomy” is then performed as a form of insurance that the infection has in fact cleared. When early sanitation of the source of infection proves surgically impossible, however, extraperitonization of the septic focus through placement of a laparostomy must be attempted.

Keywords

Infected Pancreatic Necrosis Diffuse Peritonitis Microbiological Contamination Marlex Mesh Septic Focus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kern E (1986) Zum derzeitigen Stand der chirurgischen Peritonitisbehandlung. Zentralbl Chir 111(6):305–313PubMedGoogle Scholar
  2. 2.
    Stevens LE (1983) Gauging the severity of surgical sepsis. Arch Surg 118:1190–1192PubMedCrossRefGoogle Scholar
  3. 3.
    Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) Apache II: a severity of disease classification system. Crit Care Med 13,10:818–829PubMedCrossRefGoogle Scholar
  4. 4.
    Beger HG, Krautzberger W, Bittner R (1983) Die Therapie der diffusen, bakteriellen Peritonitis mit kontinuierlicher postoperativer Peritoneal-Lavage. Chirurg 54:311–315Google Scholar
  5. 5.
    Pichlmayr R, Lehr L, Pahlow J, Guthy E (1983) Postoperativ kontinuierliche offene dorsoventrale Bauchspülung bei schweren Formen der Peritonitis. Chirurg 54:299–305PubMedGoogle Scholar
  6. 6.
    Teichman W, Eggert A, Wittmann DH, Böcker W (1985) Der Reißverschluß als neue Methode des temporären Bauchdeckenverschlusses in der Abdominalchirurgie. Chirurg 56:173–178Google Scholar
  7. 7.
    Walsh GL, Chiasson P, Hedderich G, Wexler MJ, Meakins J (1988) The open abdomen — the Marlex mesh and zipper technique: a method of managing intraperitoneal infection. Surg Clin North Am 68(1):25–40PubMedGoogle Scholar
  8. 8.
    Duff JH, Moffat J (1981) Abdominal sepsis managed by leaving the abdomen open. Surgery 90(4): 774–778PubMedGoogle Scholar
  9. 9.
    Hollender LF, Bur F, Schwenck D, Pigache P (1983) Das “offengelassene Abdomen”. Chirurg 54:316–319PubMedGoogle Scholar
  10. 10.
    Schein M, Saadia R, Freinkel Z, Decker GAG (1988) Aggressive treatment of severe diffuse peritonitis: a prospective study. Br J Surg 75(2): 173–176PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • W. Barthlen
  • H. Bartels
  • M. Hölscher

There are no affiliations available

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