Open management with mesh and zipper of patients with intra-abdominal abscesses or diffuse peritonitis.

OBJECTIVE

To evaluate the open management of intra-abdominal abscesses and persistent peritonitis by the "mesh and zipper" technique, and to assess the predictive value of the APACHE II score.

DESIGN

Prospective open study.

SUBJECTS

21 consecutive patients with life-threatening peritonitis.

INTERVENTIONS

Insertion of mesh and zipper and lavage once or twice daily with several litres of warmed saline.

MAIN OUTCOME MEASURE

Mortality.

RESULTS

Eleven of the 21 patients died (52%). The APACHE II score accurately predicted outcome, in that no patient who scored less than 20 points died, and no patient who scored more than 26 points lived.

CONCLUSION

The mesh and zipper technique with daily intraperitoneal lavage is effective in the treatment of life-threatening peritonitis and the APACHE II score is an accurate predictor of survival.