Methods of Prevention of Postoperative Peritonitis

Abstract

The aim of the study. To explore the causes and improve methods of prevention of postoperative peritonitis.
 Materials and methods. From 2012 to 2022 in the surgical department of municipal non-profit enterprise “Regional clinical hospital of the Ivano-Frankivsk Regional Council” were performed 10687 surgical interventions for various diseases and injuries of organs of the abdominal cavity. In 244 (2.3%) patients the postoperative period was complicated by the development of peritonitis, which led to repeated surgical intervention. We analyzed the results of treatment of this category of patients aged 20 to 84 years. Local peritonitis was diagnosed in 125 (51.2%) of them, diffuse peritonitis in 119 (48.8%).
 Research results. For today approaches to methods of surgical prevention of postoperative peritonitis are quite uninformative, due to the fact that in most cases the main rules of asepsis and antiseptics and appropriate surgical tactics are followed in combination with conservative intensive infusion therapy and antibacterial drugs.
 Complete removal of pathological contents from the abdominal cavity is a mandatory stage of surgery for postoperative peritonitis and one of the key factors in preventing such complications in the postoperative period as septic shock and multiple organ failure. Based on the information from the analysis of the literature, as well as on our own observations, we have developed a method of lavage of the abdominal cavity, which affects various pathogenetic factors in postoperative peritonitis.
 Conclusion. Fundamental meaning in the prevention of the development of postoperative peritonitis are the timely execution and adequate volume of the operation, the maximum evacuation of the pathological contents with subsequent lavage of the abdominal cavity by the proposed method, careful handling of the organs of the abdominal cavity (suture of questionable areas and injuries of the intestine), careful hemostasis, active-passive drainage of not only loose areas of the abdominal cavity, but also of anastomosis and abscess cavities.