Further Studies Concerning the Pathogenesis and Treatment of Peritonitis

Artz, Curtis P.; Barnett, William O.; Grogan, James B.

doi:10.1097/00000658-196205000-00015

Cited by 57 publications

(11 citation statements)

References 3 publications

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“…intramuscularly and intravenously) prompted various investigators to try and tackle the problem at its site of origin by instilling various antibiotics intraperitoneally. Results, as presented, indicate adefinite beneficial effect (1,2,3,4,5,6,7). It must be realised though that this residual peritonitis has systemic implications as confirmed by clinical and laboratory findings (pyrexia, malaise, leukocytosis, bacteraemia).…”

mentioning

confidence: 62%

Intraperitoneal Gentamicin in Appendiceal Peritonitis in Children: A Pharmacokinetic Study

Constantinides¹,

Pappis²,

Giamarellou³

et al. 1981

Eur J Pediatr Surg

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The present study was conducted in order to document the pharmacokinetic behaviour of Gentamicin when administered intraperitoneally (I.P.) in children with appendiceal peritonitis (15 patients). This pharmacokinetic behaviour was compared to that of intramuscular (I.M.) Gentamicin (12 patients). In both groups, the dose was 2.5 mg/kg/8 hours. In the I.P. group the resulting peak levels were generally low (sub-therapeutic) whilst the peak levels in the I.M. group were, in most cases, satisfactory and similar to those reported by other investigators. In both groups there was wide inter-patient variation in levels. No correlation was found between peak levels and blood Hb., haematocrit or serum urea and creatinine, but it must be noted that in most of the patients, the values of these parameters were within the normal range for their age. It emerged from the study that if Gentamicin is to be given intra-peritoneally, the dosage should be higher than that recommended for the intramuscular or intravenous route and that levels should be monitored because of interpatient variation in response.

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mentioning

confidence: 62%

Intraperitoneal Gentamicin in Appendiceal Peritonitis in Children: A Pharmacokinetic Study

Constantinides¹,

Pappis²,

Giamarellou³

et al. 1981

Eur J Pediatr Surg

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“…He reported improved survival when antibiotic was used intraperitoneally. Artz et al [21] in a dog model of fecal peritonitis found improved survival when intraperitoneal antibiotic was used. Caridis et al [22] in 1968 in a rat model, in which he produced fecal peritonitis found 30% mortality when intraperitoneal antibiotic was used as compared with 100% mortality when it was not used.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of intraoperative peritoneal lavage with super-oxidized solution and normal saline in acute peritonitis

et al. 2013

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Background: The fundamentals in the treatment of acute peritonitis include resuscitation, treatment of septicemia, control of the contaminating source and peritoneal toilet. Numerous studies have shown the roles of different solutions such as normal saline, antibiotics and betadine as intraperitoneal lavage, in reducing morbidity and mortality of peritonitis. The objective of this study was to present our findings on the role of intraperitoneal lavage with normal saline and normal saline followed by super-oxidized solution in patients with acute peritonitis. Materials and Methods: The patients were randomly allotted by slip method into two groups of 50 each. In the control group, after the definitive surgery for the pathology of peritonitis, the peritoneal cavity was lavaged with normal saline and closed after putting drains. In the study group, after the definitive surgery the peritoneal cavity was lavaged with saline followed by 100 ml of superoxidized solution and drains were closed for 1 h after abdominal closure. The patients were followed-up for morbidity and mortality. Results: Surgical site infection (SSI) was present in 27 out of 100 cases in both groups. In the study group, out of 7 infected cases, intraperitoneal fluid cultures were positive in 6 cases, but only 3 had positive swab cultures. In the control group, out of 20 infected cases, swab culture was positive in 16 cases (p = 0.0399). Among the study group, bowel sounds return in 4.10 ± 1.20 days compared to 5.9 ± 1.17 in the control group. In the study group, fever >100°F developed in 14 (28%) patients in the post-operative period whereas in the control group it was 29 (58%) (p < 0.0024). SSI rates in the two groups were (7/50) 14% and (20/50) 40% respectively (p = 0.0034). Conclusion: This study suggests that super-oxidized solution is effective and safe in reducing post-operative complications including SSI, burst abdomen and episodes of post-operative fever.

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“…Price 4 y Torek 5 , a principios del siglo pasado demostraron la efectividad del desbridamiento y lavado de la cavidad peritoneal en pacientes con apendicitis aguda, reduciendo en forma significativa la mortalidad posoperatoria. Artz 6 , en 1960 utilizó la irrigación durante el acto quirúrgico con antibióticos y Schumer 6 la irrigación continua posoperatoria intraperitoneal. Huspeth 7 propuso el desbridamiento radical de la superficie peritoneal tanto visceral como parietal.…”

Section: Antecedentes Históricosunclassified

Cierre secuencial de la pared abdominal Una nueva técnica quirúrgica diseñada en el Centenario Hospital Miguel Hidalgo para el manejo del abdomen abierto

Flores-Álvarez¹,

Rivera-Barragán²,

Torre-González³

2010

LUXMED

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El abdomen abierto es una técnica quirúrgica empleada en el tratamiento de los pacientes con procesos infecciosos peritoneales severos, en el trauma abdominal grave en pacientes que requieren cirugía de control de daños y en el manejo del síndrome de hipertensión abdominal. El tratamiento con abdomen abierto ocasiona riesgos trascendentales para el paciente tales como alteraciones hidroelectrolíticas, contaminación externa de órganos abdominales, desarrollo de fístulas intestinales, adherencias obstructivas, defectos herniarios gigantes de la pared abdominal y la presencia de grandes heridas cruentas con cicatrización lenta, con consecuencias estéticas y funcionales importantes. Existen técnicas que además de manejar el abdomen abierto tratan de evitar la retracción aponeurótica y el desarrollo de hernias ventrales gigantes que requieren de una compleja reconstrucción tardía de la pared abdominal. El Cierre Secuencial de la Pared Abdominal es una técnica desarrollada en el Centenario Hospital Miguel Hidalgo en la que se emplean materiales y métodos utilizados en diversas técnicas del manejo de abdomen abierto, adecuados a la infraestructura del hospital y a la disponibilidad de materiales. Los beneficios del procedimiento propuesto son reparar, drenar, descomprimir y ofrecer control de la pared abdominal en aquellos pacientes que requieren tratamiento con abdomen abierto. La técnica tiene la ventaja de que el paciente puede permanecer en su cama, sin necesidad de reiterados ingresos a quirófano y debido a que se trata de una técnica sencilla y fácil de realizar así como por el uso de materiales inertes se asocia a un bajo índice de complicaciones y resultados iniciales alentadores.

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Further Studies Concerning the Pathogenesis and Treatment of Peritonitis

Cited by 57 publications

References 3 publications

Intraperitoneal Gentamicin in Appendiceal Peritonitis in Children: A Pharmacokinetic Study

Intraperitoneal Gentamicin in Appendiceal Peritonitis in Children: A Pharmacokinetic Study

Evaluation of intraoperative peritoneal lavage with super-oxidized solution and normal saline in acute peritonitis

Cierre secuencial de la pared abdominal Una nueva técnica quirúrgica diseñada en el Centenario Hospital Miguel Hidalgo para el manejo del abdomen abierto

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