Relaparotomies for abdominal sepsis--why, when, how? A collective review.

Despite numerous reports in the recent literature, the indications for relaparotomies for abdominal sepsis are still not clear cut. In particular there is no consensus concerning the decision or the optimal time to reoperate. There is more benefit than hazard in a low threshold for surgically exploring the critically ill patient, especially the one who cannot easily be assessed clinically. Exclusive reliance on radiological confirmation of ongoing sepsis might delay diagnosis and treatment. Relaparotomy at regular intervals (preferably every 24-48 hours) should be done until complete eradication of sepsis is achieved.