Management of Peritonitis in the Critically Ill Patient

Topical negative pressure in managing severe peritonitis: A positive contribution?

“…TNP facilitates temporary abdominal wall closure [7] , controlled collection of exudate [2] and the small bowel "cocoons" inside the abdominal cavity, preventing interloop abscesses [19] . Furthermore the Abdominal Dressing System allows easy access for a second look [3] .…”

“…It was suggested [2] that a second look to be beneficial for patients with an APACHE Ⅱ score of 10 to 25. A score greater than 26 has a high mortality rate regardless of the strategy used, and a score less than 10 has a good prognosis whatever the approach used.…”

“…All patients in this study survived their surgical admission. Delayed abdominal wall closure was achieved in75% of patients and intestinal continuity was restored in two patients when conditions became favourable; this is known as delayed primary anastomosis [2] . There are very few reports of the use of TNP and the Abdominal Dressing System in peritonitis [7] .…”

“…They include elimination of the septic focus, removal of necrotic tissue, and drainage of purulent material [1] . Despite advances in antibiotics therapy and intensive care support, mortality and morbidity remain high [2] . In certain cases of severe peritonitis, the surgeon may feel that a further look is required to achieve these goals [1] .…”

Spontaneous seromuscular laceration of the sigmoid colon: a case report

“…Rapid intravenous hydration and surgical intervention are critical and very often result in preservation of life 21. Additional interventions such as nasogastric suctioning, blood transfusions and administration of antibiotics can be implemented on a case‐by‐case basis.…”