Stage lavage

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The stage lavage (also: programmed stage lavage ) is in surgical parlance the planned relaparotomy carried out at predetermined time intervals for high-grade inflammatory diseases of the abdominal cavity. The reason is usually purulent peritonitis .

indication

High-grade, difficult to control, mostly bacterial , septic inflammatory processes in the abdomen turn out to be incurable from the outset or in the course of the normal surgical procedures. In this type of inflammatory condition, only the repeated surgical removal of inflammatory products (accumulations of fibrin or its derivatives, flushing out of pus , removal of blood accumulations ) can lead to success. In such a situation , the surgeon usually specifies : “Stage lavage every xx (often 48) hours”.

execution

Different approaches are common:

  • Programmed relaparotomy with definitive abdominal closure: After the "cleaning measures" in the abdominal cavity, it is closed as usual.
  • Zipper treatment : a zipper is sewn onto the fascia, which allows quick and easy access to the abdomen.
  • Open abdominal treatment : the abdomen is not closed, but only covered with foil that is placed under a small vacuum.

There is still no consensus on these three forms of treatment.

The stage lavage is ended with an abdominal closure when the inflammatory changes have clearly subsided. Usually an operation later than really necessary.

forecast

If the inflammatory process can be mastered, the prognosis is good. However, there are many cases in which the abdominal space needs to be "revised" 20 times or more. These patients are sometimes anesthetized for> 100 days. The reconstruction of the abdominal wall becomes more difficult depending on the time. Incisional hernias are more the rule than the exception.

The overall prognosis depends on the underlying disease.