A New Method of “Open” Surgical Treatment of Severe Diffuse Peritonitis (Experimental Study)

Abstract

ABSTRACTOptimal management of severe diffuse peritonitis remains controversial. A major problem in the surgical treatment of peritonitis is to obtain a complete clearance septic foci in the peritoneal cavity which may lead to persistence of sepsis and multiple organ failure. With the “open packing” approach, repeated closure of the midline fascia is complicated by loss tissue integrity and suture strength. Ttappenlavage (ETL) is a new concept of scheduled multiple laparotomies with abdominal lavage for diffuse peritonitis. Its purpose to ensure exclusion of the infected source, promote maximal elimination of toxic necrotic material and allow prompt recognition of complications to effect immediate repair. The author describes his experience with ETL in experimental study on 45 dogs with generalized suppurative peritonitis. The advantages of ETL using a laparostomic set are as follows: a much more effective drainage of the peritoneal cavity; early diagnosis of eventual recurrent peritonitis; easy and rapid access for reoperation and drainage when necessary; presentation of tension necrosis and dehiscence.