Controlled open drainage of severe intra-abdominal sepsis
S. J. Bradley, G. J. Jurkovich, N. W. Pearlman and G. V. Stiegmann
Controlled open drainage of the abdomen (gauze in plastic intestinal
bag/surgical glove packing of abscesses; wound closure only to the degree
needed to prevent evisceration) was compared with closed drainage (soft
rubber or sump drains; complete fascial closure) in 31 patients with severe
intra-abdominal sepsis. Three (23%) of 13 patients died after open drainage
vs eight (44%) of 18 after closed drainage. The difference was attributable
to a lower incidence of recurrent abscesses in the former group (one
recurrence) than in the latter (six recurrences). Thus, controlled open
drainage may improve survival in this highly lethal condition.