title: Staged peritoneal lavages with the aid of a Zipper system in the treatment of diffuse peritonitis.
abstract: A major problem in the surgical treatment of diffuse peritonitis is to obtain a complete clearance of septic foci in the peritoneal cavity which may lead to persistence of sepsis and multiple organ failure. We describe our experience with staged abdominal re-explorations using a Zipper system in 23 patients with a mean APACHE II score of 20.3 (s.e.m: 1.5). A total of 91 lavages were done in these patients. Overall mortality was 39%. None of the patients having an APACHE II score between 10 and 20 died whereas the predicted mortality was 15%-45%. After successful treatment, primary closure was possible in 8 of the 14 surviving patients. Large incisional hernias developed in 6 patients. One patient eviscerated two years after complete granulation of his laparostoma. Staged abdominal re-explorations using a Zipper system is an useful tool in the treatment of diffuse peritonitis.
authors.affiliation: Dept. of Surgery, Academic Hospital University of Antwerp, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Hubens
authors.forename: C
authors.initials: C
authors.lastname: Lafaire
authors.forename: M
authors.initials: M
authors.lastname: De Praeter
authors.forename: D
authors.initials: D
authors.lastname: Ysebaert
authors.forename: W
authors.initials: W
authors.lastname: Vaneerdeweg
authors.forename: L
authors.initials: L
authors.lastname: Heytens
authors.forename: E
authors.initials: E
authors.lastname: Eyskens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004066:Digestive System Diseases / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000009:adverse effects / Q000379:methods*; D010538:Peritonitis / Q000209:etiology / Q000628:therapy*; D012086:Reoperation; D012720:Severity of Illness Index