OUTCOME OF SKIN ONLY TEMPORARY ABDOMINAL CLOSURE METHOD AND REPEATED PERITONEAL WASH IN PATIENTS WITH SECONDARY PERITONITIS

Abstract

OBJECTIVE: To determine the outcome of skin only temporary abdominal wall closure and repeated
peritoneal wash therapy in the management of secondary peritonitis in terms of fascial closure and mortality.
MATERIAL AND METHODS: This prospective descriptive study was conducted on 80 patients with
secondary peritonitis, selected by convenience non probability sampling technique after fulfilling the
inclusion and exclusion criteria, in emergency surgical department of Govt PGMI Lady Reading Hospital
Peshawar from January 2011 to July 2012. Patients were diagnosed on the basis of history, clinical
examination, heamatological and radiological investigations , operated in casualty and skin only
temporary abdominal closure method was applied with prolene 2/0 and planned re-laparotomy was carried
out after 24 hours. Further re-laparotomies were decided by the operating surgeon till proper fascial closure.
The impact of skin only closure and number of operations were analyzed postoperatively in terms of fascial
closure and mortality. The demographic and clinical ( intraoperative and postoperative ) data of the all
patients such as name, age, gender, duration of hospital stay, indication and number of operations were
recorded in a proforma.The data was analyzed with SPSS version 16. Frequency and percentages were
computed for categorical variables such as gender and number of operations, fascial closure and mortality
while numerical variables such as age, hospital stay was presented with Mean ± SD.
RESULTS: A total of 80 patients were included in the study and out of which 55 (68.8%) were male and 25
(31.2% ) female with male to female ratio of 2.2:1 . The age of patients ranged from 18 to 65 years. The mean
age was 37.83 ±1.194. The ranged of re-operations were 1 to 4 with mean 2.06± 0.785. The ranged of
hospital stay was 9- 50 days with mean 21± 7.719.
The fascial closure was 82.5% and mortality was 13.8%.
CONCLUSION: Peritoneal wash is life saving procedure in the treatment of secondary peritonitis and skin
only temporary abdominal closure is easy, quick and fascial preserving procedure. Both techniques should
be encouraged in secondary peritonitiscases.
KEYWORDS:Peritonitis, Re-Laparatomy,Skin Closure.