[Laparotomy closure in advanced peritonitis]. / Sposoby zakrytiya laparotomnoi rany pri rasprostranennom peritonite.
Khirurgiia (Mosk)
; (7): 30-35, 2016.
Article
in Ru
| MEDLINE
| ID: mdl-27459485
ABSTRACT
AIM:
to improve the results of advanced peritonitis management. MATERIAL ANDMETHODS:
743 patients with advanced peritonitis were studied. Patients were divided into 2 groups depending on treatment strategy.RESULTS:
Programmed relaparotomy combined with removable draining musculoaponeurotic seams during laparotomy closure decreased mortality from 47.8±2.7% to 24.1±2.3% (p<0.001) and provided 4-fold reduction of postoperative suppuration incidence (p<0.001). Refusal from removable draining musculoaponeurotic seams and use of only cutaneous seams in persistent abdominal hypertension were associated with further decrease of mortality to 15.8±2.7% (p<0.05).CONCLUSION:
Programmed relaparotomy combined with removable draining musculoaponeurotic seams are advisable for advanced peritonitis management. Laparotomy closure with only cutaneous seams is indicated in case of persistent abdominal hypertension. Large eventration always requires abdominal wall repair. APACHE-III scale scores have significant prognostic value in patients with advanced peritonitis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peritonitis
/
Postoperative Complications
/
Reoperation
/
Peritoneal Lavage
/
Sepsis
/
Abdominal Wound Closure Techniques
/
Laparotomy
/
Multiple Organ Failure
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
/
Europa
Language:
Ru
Journal:
Khirurgiia (Mosk)
Year:
2016
Document type:
Article