Intra-operative peritoneal lavage – who does it and why?
| Autor: | O J H Whiteside, S Thrush, M G Tytherleigh, R B Galland, R Farouk |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Intra operative medicine.medical_treatment Frequency of use Sodium Chloride Postal questionnaire Lavage fluid medicine Humans Peritoneal Lavage Povidone-Iodine Saline Intraoperative Care business.industry Water Professional Practice General Medicine Faecal peritonitis Surgery medicine.anatomical_structure General Surgery Health Care Surveys Anti-Infective Agents Local Abdomen business Cancer surgery Research Article |
| Zdroj: | Annals of The Royal College of Surgeons of England. 87:255-258 |
| ISSN: | 1478-7083 0035-8843 |
| Popis: | INTRODUCTION: Intra-operative peritoneal lavage (IOPL) is widely practised but its benefits are unclear. The frequency and pattern of its use amongst general surgeons is investigated. METHODS: A postal questionnaire was sent to 153 general surgical consultants and registrars enquiring about their use of IOPL. The surgeon was asked the volume and type of lavage fluid used, under various circumstances. RESULTS: 118 (77%) questionnaires were returned. 115 (97%) surgeons used IOPL. The majority of surgeons (61%) lavaged until the fluid was clear, 20% used more than 1 l and 17% used between 500-1000 ml. In the case of the dirty abdomen (i.e. gross pus or faecal peritonitis), 47% used saline as the lavage fluid, 38% aqueous betadine, 9% water and 3% antibiotic lavage. Similar results were found in the case of a contaminated abdomen (i.e. a breached hollow viscus). 34% of surgeons used IOPL during clean cases. 36% used water lavage during intra-abdominal cancer surgery; 21% lavaged with saline and 17% with betadine. More registrars (47%) than consultants (29%) lavaged with water during cancer surgery. Consultants, however, used more aqueous betadine. CONCLUSIONS: The frequency of use and choice of lavage fluid varies widely. The successful management of the septic abdomen rests on at least 3 tenants - systemic antibiotics, control of the source of infection and aspiration of gross contaminants. There is little good evidence in the literature to support IOPL in the management of the septic abdomen. The use of IOPL during cancer surgery is supported by in vitro evidence. The current use of IOPL, as shown by this study, appears not to be evidence based. |
| Databáze: | OpenAIRE |
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