Open versus closed diagnostic peritoneal lavage. A multiphasic prospective randomized comparison.

A total of 118 trauma patients were prospectively randomized to receive either open or closed peritoneal lavage. In addition, comparisons were made between using an infraumbilical versus a supraumbilical approach in patients with pelvic fractures. No statistical difference was noted between the open and closed groups, despite the overall accuracy rate of 96.6%. The supraumbilical approach was vastly superior to the infraumbilical approach in patients with pelvic fracture with an accuracy rate of 90.9% versus 57%. In this regard, use of the infraumbilical approach in this setting is to be highly discouraged. Finally, patient body habitus, technique, and physician experience all play a role in the outcome of the lavage.