October 1982

To Irrigate or Not in Generalized Peritonitis

Author Affiliations

Athens, Greece

Arch Surg. 1982;117(10):1371. doi:10.1001/archsurg.1982.01380340085022

To the Editor.—In Dr Hunt's study (Archives 1982;117:209-212) evaluating peritoneal lavage as adjuvant treatment of generalized peritonitis, important confounding factors were analyzed for the entire study as a whole, but not separately for each group. Therefore, the comparability between these groups may be questioned. For example, it was stated that perioperative chemotherapy was given, but it is not known whether this was begun during the most crucial preoperative or intraoperative phase in all cases. Likewise, no note was made of the possible placement of drains in patients who did not undergo lavage postoperatively (groups 1 and 2). This is important because drains often cause intra-abdominal infection rather than prevent it, particularly in seriously ill or immunologically compromised patients. It also would be essential to know how many wounds in each group were left open, since by applying any one of the aforementioned policies more consistently to one group, the

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