Demkovych O. Optimization of Diagnostic Peritoneal Lavage in Patients with Generalized Peritonitis

The dissertation is devoted to the surgical treatment of Generalized Peritonitis. Diagnostic peritoneal lavage, used for intra- and postoperative lavage of the abdominal cavity, implying the use of aqueous antiseptic solutions, such as chlorhexidine gluconate 0,02%, decamethoxine 0,02% and isotonic saline 0,9% are effective only first 12-24 hours, because due to abdominal adhesions the antiseptic leaks through the channels arising. Lavage of the parietal and visceral peritoneum is not happening, abdominal abscesses occur. Thus, unsatisfactory outcomes of combined surgical treatment of generalized peritonitis are predominantly associated with ineffective postoperative peritoneal lavage, proving the necessity of its improvement and effectiveness enhancement. Consequently, we have the principal objective of the dissertation – improving outcomes of combined surgical treatment of patients with generalized peritonitis by justification, development and adoption of the appropriate technique of peritoneal lavage. The results obtained using the antiseptic gel solution (decamethoxine combined with hyaluronic acid) were indicative of significant benefits comparing to the aqueous solution of chlorhexidine 0,02% used for peritoneal lavage in generalized peritonitis.Such outcomes are achieved du to the fact that the antiseptic gel solution covers the maximum area of the visceral and parietal peritoneum by reducing adhesion, antiseptic spreads uniformly in the abdominal cavity, the probability of infection to occur in interloop foci is also reduced.