title: [Results of therapy combining peritoneal lavage and local application of antibiotics in 250 patients with acute perforating appendicitis].
abstract: Since 1967, 2480 appendectomies have been performed at the St. Lucas Hospital (Amsterdam) and the St. Annadal Hospital (Maastricht), of which 250 were for perforated appendicitis. A so-called 'combined method' of treatment was used in all these cases: during the operation saline was used to lavage the peritoneal cavity with the patients in the reverse-Trendelenburg position. Antibiotics were left in the peritoneal cavity. No intraperitoneal drainage was performed, but the wound was drained for 5 days. Postoperative treatment consisted of nasogastric suction and parenteral antibiotics for 5 days in combination with anticoagulation. With thus combined approach one death was seen in 250 cases. There were 20 cases of wound infection (8%), 7 pelvic abscesses (2.8%), and 2 retroperitoneal abscesses. No thromboembolic complications were seen because of the use of routine anticoagulation. For 191 patients (77%), total hospitalization was less than 14 days. This method of treatment is compared with recent reports in literature.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001064:Appendicitis / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D010529:Peritoneal Cavity; D011184:Postoperative Period; D013752:Tetracycline / Q000627:therapeutic use; D007507:Therapeutic Irrigation
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D013752:Tetracycline
vernacular_title: Ergebnisse einer kombinierten Behandlung von Lavage der Bauchhöhle und lokal verabreichten Antibiotica bei 250 Patienten mit Appendicitis acuta perforata.