DIFFERENTIATED THERAPEUTIC STRATEGY OF PE RITONITIS - CLOSED ONE-STAGE LAPAROTOMY OR OPEN TREATMENT PROGRAMMED RELAPAROTOMY

307 Patients with intraabdominal infections were operated between 8/19 88 to 8/1991. Simple clinical parameters (according to the Mannheimer Peritonitis-Index) were evaluated before treatment. The classical ther apeutic concept of one-stage laparotomy with drainage of the abdomen w as performed in 223 patients initially. Because of recurrent infection and other complications in 19 % of them 1 - 2 relaparotomies had to b e done, and in 8 % change to open treatment was necessary. Open treatm ent with planned relaparotomy was necessary in alltogether 101 patient s, 93 abdominal complications due to primary disease or sepsis were de tected in 43 of them. Abdominal treatment was successful (eradication of source of infection, no recurrence of infection) in 98 % of the pat ients after closed and in 84 % after open treatment. Mortality was 6.8 % vs. 32.7 % and on the whole 15.3 %.