Open treatment of peritonitis: an argument against.

We conclude that open management of advanced peritonitis may provide improved drainage, but it does so at an intolerable cost of increased mechanical lesions, namely, fistulas. The theories of animal investigators need to be tested at the bedside and in the hospital operating room before this idea receives any further consideration. "Semi-open" treatment has been widely and usefully used by many surgeons. Unfortunately, it provides less than total drainage and has its own set of major problems related to mesh removal and/or ultimate wound closure. We think that a better alternative for future controlled study is the sporadically espoused but impressively effective continuing peritoneal lavage with dilute solutions of antibiotics.