THE TREATMENT OF INTRAABDOMINAL SEPSIS WITH OPEN ABDOMEN TECHNIQUE

Abstract

The purpose of this study is defining the effectivity of open management of intraabdominal sepsis. Intraabdominal sepsis is usually fatal in surgical patients unless adequate drainage and wide debridman are possible. Leaving the abdomen open has popularized a new concept of multiple laparotomies with abdominal lavage by leaving the abdomen open in a short period time in the surgical literature, 20 patients with intraabdominal sepsis underwent multiple abdominal lavages and left their abdomen open investigated prospectively from the point of recovery, mortality and morbidity rate in this study. The open method of management has not made the treatment of septic abdomen much easier; the morbidity and mortality rates are still high in the secritically ill patients. Mortality and complication rates have been found as 30% (six patients) and 25% (five patients) respectively. Mortality causes were multi organ failure in three patients, nosocomial infections in three patients. Complications were small bowel fistula in three patients and evisceration in two patients after closure of the abdomen. Open management of the septic abdomen followed by planned reoperations is a reasonably successful alternative for the patients with generalized peritonitis. Because of the management and clinical surveillance of these patients require specific expertise, we believe that the care of patients is best undertaken with close surveillance and cooperation among the specialties in medicine.