Open versus closed diagnostic peritoneal lavage: a comparison on safety, rapidity, efficacy. 1998

G C Velmahos, and D Demetriades, and M Stewart, and E E Cornwell, and J Asensio, and H Belzberg, and V Berne
Department of Surgery, University of California, Los Angeles, USA.

There is considerable debate between the proponents of open and closed diagnostic peritoneal lavage (DPL). A prospective study was undertaken on 130 patients submitted to DPL. We performed 55 (42.3%) closed and 75 (57.7%) open lavages with sensitivity and specificity of 100 and 96.6% for the former and 92.2 and 100% for the latter. The mean time for insertion of the catheter and initiation of fluid infusion was significantly less in the closed DPL group, and so were the number of cases with prolonged procedures. No intra-abdominal or wound complications were detected with either method, but there were 10 DPL failures due to inability to conclude the procedure successfully and derive a definite result. Eight of these (10.6%) belonged to the open group and two (3.6%) to the closed (P < 0.05). Our findings suggest closed DPL is as equally sensitive and specific as closed DPL, but is more expeditious and offers inconclusive results less often. Both procedures are useful and should be parts of surgical training.

UI MeSH Term Description Entries
D008297 Male Males
D010533 Peritoneal Lavage Washing out of the peritoneal cavity. The procedure is a diagnostic as well as a therapeutic technique following abdominal trauma or inflammation. Irrigation, Peritoneal,Lavage, Peritoneal,Peritoneal Irrigation
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000007 Abdominal Injuries General or unspecified injuries involving organs in the abdominal cavity. Injuries, Abdominal,Abdominal Injury,Injury, Abdominal
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014949 Wounds, Nonpenetrating Injuries caused by impact with a blunt object where there is no penetration of the skin. Blunt Injuries,Injuries, Nonpenetrating,Injuries, Blunt,Nonpenetrating Injuries,Blunt Injury,Injury, Blunt,Injury, Nonpenetrating,Nonpenetrating Injury,Nonpenetrating Wound,Nonpenetrating Wounds,Wound, Nonpenetrating

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