The zipper-mesh method for treating delayed generalized peritonitis.

Recently, many articles have been published related to the "open abdomen" concept which is performed particularly on patients with delayed generalized peritonitis. Since most arguments still support the effectiveness of this method and the results have been mostly favourable, it was decided to use the technique on 14 patients with peritonitis. Commercial zippers either with or without mesh were used on all. Four patients, however, died in the very early postoperative period and were excluded from the study. Others were examined as to the operative findings, period of delay, concomittant diseases, primary operations, indications of the technique, the number and type of the reinterventional procedures, status of remote organ failure, expected and realized mortality. Forty laparatomies were performed on 10 patients. In addition to obtaining a clean intraperitoneal cavity, some additional procedures such as anastomotic repair or gastroenterostomy could be done. The mean period of ventilator support was 27 h, the ambulation period was 3 days. The start of enteral nutrition early was able to be achieved more easily. In the patients whose expected mortality rate was as high as 70%-90%, a rate of 40% was established in those ten patients.