The treatment of generalized peritonitis by closed postoperative peritoneal lavage. A critical review of the literature.

Thirty-nine studies of closed postoperative peritoneal lavage were reviewed, including four prospective, randomized studies, eight nonrandomized comparative studies, and 27 noncomparative studies. Mortality rates and abscess rates were determined for various subsets of patients. Despite the large number of studies performed, the therapeutic value of this procedure remains unknown. It is unlikely that further noncomparative or nonrandomized studies will yield useful information. There remains a need for a large-scale, prospective, randomized study to evaluate closed postoperative peritoneal lavage. Smaller prospective, randomized studies can contribute meaningfully if data on the specific causes of peritonitis, severity of disease, and patient age and chronic health status are provided in the form of widely used and well-validated stratification systems.