SCHEDULED RELAPAROTOMIES USING A ZIPPER SYSTEM FOR THE TREATMENT OF DIFFUSE GENERALIZED PERITONITIS IN CHILDREN

Citation
G. Roeyen et al., SCHEDULED RELAPAROTOMIES USING A ZIPPER SYSTEM FOR THE TREATMENT OF DIFFUSE GENERALIZED PERITONITIS IN CHILDREN, Acta Chirurgica Belgica, 96(5), 1996, pp. 201-205
Citations number
41
Categorie Soggetti
Surgery
Journal title
ISSN journal
00015458
Volume
96
Issue
5
Year of publication
1996
Pages
201 - 205
Database
ISI
SICI code
0001-5458(1996)96:5<201:SRUAZS>2.0.ZU;2-6
Abstract
In the treatment of diffuse peritonitis, planned relaparotomies with p eritoneal lavages using a zipper system (EthiZip(R) Ethicon) are somet imes necessary to obtain a complete eradication of the infectious focu s. While most reported series are dealing with an adult population, th is review focuses on the treatment of peritonitis using a zipper syste m in a paediatric age group. In a period of 3 years, insertion of a zi pper device and peritoneal lavages were considered necessary to contro l intraabdominal sepsis in 7 children (age varying from 5 days to 13 y ears). They consequently underwent planned relaparotomies with periton eal lavages every 24 to 48 hours. The peritonitis was caused by necrot izing enterocolitis (3 patients), postoperative complications (3 patie nts) and long existing perforated appendicitis (1 patient). Physical s tatus, assessed by the Acute Physiologic Score (A.P.S.), varied from 1 2 to 22 (mean 17.7). Usually more than one lavage was necessary (1 to 3, mean 1.9) before the abdomen was considered clean and the zipper co uld be removed. Closure of the abdominal cavity could be achieved prim arily in all cases. All patients survived. Although no statistically s ignificant conclusions can be drawn from this small series and althoug h it is unclear whether these children would not have survived without the zipper, this review shows that planned relaparotomies with perito neal lavages using a zipper system can be performed safely even in ver y small children.