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Published July 31, 2020 | Version v1
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Evaluation of the efficacy of antiseptic gel solution for peritoneal lavage in generalized peritonitis

  • 1. P. L. Shupyk National Medical Academy of Postgraduate Education

Description

Feleshtynsky Ya. P., Demkovych O. P., Smishchuk V. V. Evaluation of the efficacy of antiseptic gel solution for peritoneal lavage in generalized peritonitis. Journal of Education, Health and Sport. 2020;10(7):318-329. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.07.034

https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.07.034

https://zenodo.org/record/4031303

 

 

 

 

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

© The Authors 2020;

This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland

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provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.

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The authors declare that there is no conflict of interests regarding the publication of this paper.

 

Received: 19.06.2020. Revised: 09.07.2020. Accepted: 31.07.2020.

 

 

Evaluation of the efficacy of antiseptic gel solution for peritoneal lavage in generalized peritonitis

 

Ya. P. Feleshtynsky, Head of the Department, M.D., Professor

O. P. Demkovych, Postgraduate Student

V. V. Smishchuk, Assistant Professor, Candidate of Medical Sciences

 

P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Department of Surgery and Proctology

 

Abstract

In 80-85% of cases successful management of generalized peritonitis depends on the effect of intraoperative and postoperative peritoneal cavity lavage.

The aim of the study is to improve the effectiveness of peritoneal lavage with antiseptic gel solution in patients with generalized peritonitis.

Materials and methods. The analysis of the comprehensive treatment was performed in 96 cases diagnosed as generalized peritonitis at the clinic of the Department of Surgery and Proctology of P.L. Shupyk National Medical Academy of Postgraduate Education from 2016 to 2020. The patients were 23 to 76 years old (the mean age was 54.3 ± 2.1). Among them there were 63 males (65.6%) and 33 females (34.4%). Depending on the method of peritoneal cavity lavage, patients were categorized into two groups. Group I or main group, including 47 (48.96%) patients, underwent peritoneal lavage with an antiseptic gel solution in compliance with the method of our invention (patent of Ukraine № 123924 for the utility model as of 12 March 2018). Group II or comparison group, including 49 (51.04%) patients, underwent peritoneal lavage with 0.02% chlorhexidine bigluconate.

Results. In group I, the use of antiseptic gel solution for peritoneal lavage reduced the number of strains from 94 to 49 (p <0.01), the number of colonies - from 43.69 Lg CFU / mL to 20.08 Lg CFU / mL, Δ = 23.61 Lg CFU / mL (p <0.01), whereas in group II, the number of strains decreased from 93 to 68 (p <0.01) and the number of colonies from 42.68 Lg CFU / mL to 30.87 Lg CFU / mL, Δ = 11.81 Lg CFU / mL (p <0.01). The study found significant reduction of the number of E. Coli strains to 28 in group I compared with 41 in group II and the number of colonies to 3.35 Lg CFU / mL in group I compared with 5.28 Lg CFU / mL in group II. The number of leukocytes in patients of group I was lower and amounted to 7.2 ± 0.9 comparing to 10.5 ± 1.2 in patients of group II (pI-II <0.05). Dynamics of procalcitonin concentration before and after peritoneal lavage: from 5.7 ± 0.4 ng / ml to 1.1 ± 0.1 in group I, from 5.9 ± 0.5 ng / ml to 3.54 ± 0, 4 ng / ml in group II (pI-II <0.05). The clinical results of the complex treatment of patients with generalized peritonitis showed that in group I the complications occurred in 10.6% (5/47) of peritonitis cases, and in group II - in 26.5% (13/49) of peritonitis cases. In group I, the average length of hospital stay was 9 ± 1.4 days comparing to 14 ± 2.2 days in group II (p <0.01).

Conclusions

In generalized peritonitis, an antiseptic gel solution for peritoneal lavage showed higher efficacy than water-based antiseptic due to its ability to cover the entire parietal and visceral peritoneal surface as well as maximum exposure, thus reducing the number of strains of microorganisms from 94 to 49, the number of colonies from 43,69 lg CFU / ml to 20.08 lg CFU / ml, whereas the use of water-based antiseptic helped to decrease the number of strains of microorganisms from 93 to 68, the number of colonies from 42.68 lg CFU / ml to 30.87 lg CFU / ml.

In the comprehensive surgical treatment of patients with generalized peritonitis,  peritoneal lavage with antiseptic gel solution helped to reduce the overall incidence of postoperative complications to 10.6% in group I comparing to 26.5% in group II, the occurrence of abdominal abscesses to 2.13% in group I comparing to 8,16% in group II, early adhesive intestinal obstruction to 2.13% in group I comparing to 8.16% in group II, postoperative wound suppuration to 6.38% in group I comparing to 10.2% in group II. Peritoneal lavage with antiseptic gel solution also decreased the average length of in-hospital stay to 9 ± 1.4 in group I comparing to 14 ± 2.2 days in group II.

Key words: peritonitis; abdominal abscesses; peritoneal cavity lavage; antiseptic solutions.

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