[Evaluation of methods for local treatment of generalized purulent peritonitis of appendicular origin in children].
The work is based on the analysis of treatment of 212 children with generalized purulent peritonitis of appendicular origin at 7 different pediatric surgical clinics of Russia. The total mortality rate was 1.9%. It is shown that the removal of pus from the abdominal cavity by aspiration has no advantages over its removal by means of moistened tampons. Irrigation of the abdominal cavity during the operation does not affect essentially the results of treatment of patients with generalized purulent peritonitis. Drainage of the abdominal cavity by means of an aspiration drain installed properly and methodically leads to a lesser number of postoperative abdominal abscesses and continuing peritonitis. Administration of antibiotics into the abdominal cavity at the end of the operation and in the postoperative period does not influence significantly a decrease in the incidence of postoperative purulent complications. Peridural anesthesia has no advantages over other methods in the control of intestinal paresis and prevention of adhesive intestinal obstruction.