Open management with mesh and zipper of patients with intra-abdominal abscesses or diffuse peritonitis.
OBJECTIVE
To evaluate the open management of intra-abdominal abscesses and persistent peritonitis by the "mesh and zipper" technique, and to assess the predictive value of the APACHE II score.


METHODS
Prospective open study.


METHODS
21 consecutive patients with life-threatening peritonitis.


METHODS
Insertion of mesh and zipper and lavage once or twice daily with several litres of warmed saline.


METHODS
Mortality.


RESULTS
Eleven of the 21 patients died (52%). The APACHE II score accurately predicted outcome, in that no patient who scored less than 20 points died, and no patient who scored more than 26 points lived.


CONCLUSIONS
The mesh and zipper technique with daily intraperitoneal lavage is effective in the treatment of life-threatening peritonitis and the APACHE II score is an accurate predictor of survival.
Hakkiluoto
A
A
Satakunta Central Hospital, Pori, Finland.
Hannukainen
J
J
D000038:Abscess / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000295:instrumentation*; D010538:Peritonitis / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013536:Suture Techniques / Q000295:instrumentation*