Open treatment of abdominal septic catastrophies

Abstract

Abstract From 1973 to 1981, a total of 30 patients undergoing reoperative surgery for serious septic complications were treated without closure of the abdominal cavity. The open wound was covered with gauze soaked in saline. Intraabdominal abscesses could then be evacuated directly, if necessary, under slight general anesthesia in the patient's own bed. Reperitonealization and excess growth of granulation tissue was seen within 2 weeks. Sixteen patients survived. In 10 of these, the wound healed secondarily without any other treatment. In the remaining 6, split‐skin grafts or a pedicled flap was necessary. In 4 patients the abdominal wall almost reestablished itself. The remaining 12 patients showed larger or smaller defects with negligible problems. Patients with severe abdominal sepsis, associated with necrotic wound edges, multiple laparotomies, and multiple organ failures should have the abdominal cavity left completely open.