sodium-hypochlorite and Peritonitis

To evaluate antimicrobial properties of Dermacyn in abdominal infections, and to develop a new method for peritoneal lavage without using antibiotics.. One hundred and ten patients suffering from intestinal perforation (abdominal closed injury), who had been treated with opened surgical repair or partial intestinal resection, were enrolled in this study. In the study group, Dermacyn was used for peritoneal lavage. During the same period, 102 patients with intestinal perforation of abdominal closed injury and opened repair or partial intestinal resection were enrolled as a control group. For the control group, metronidazole physiological saline was used for peritoneal lavage. Patients from both groups had a postoperative indwelling peritoneal drainage tube. Five objective indicators were studied and compared at 24, 48, and 72 hours: volume of drainage, drainage fluid culture, blood routine test, C-reactive protein, calcitonin and antibiotics dose.. There were no significant differences between the drainage volumes in two groups three days after the operation. There were significant differences in the nature of the drainage fluid, bacterial culture results, blood routine, C-reactive protein and procalcitonin between the two groups. In the experimental group, after the Dermacyn flushing, the average volume of peritoneal drainage fluid was reduced (from 30 to 5 mL) from 24 to 72 hours postoperatively.. The use of Dermacyn as an antibiotic agent for intraoperative peritoneal lavage was effective in reducing the risk of infection, due to its broad-spectrum bactericidal effect. Dermacyn could be used safely to perform peritoneal flushing to clean the operation site.

Topics: Abdominal Injuries; Adolescent; Adult; Aged; Anti-Infective Agents, Local; Ascitic Fluid; C-Reactive Protein; Calcitonin; Colectomy; Colostomy; Drainage; Drug Combinations; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Hypochlorous Acid; Intestinal Perforation; Male; Metronidazole; Middle Aged; Peritoneal Lavage; Peritonitis; Sodium Hypochlorite; Surgical Wound Infection; Wounds, Nonpenetrating; Young Adult

The article presents an analysis of surgical treatment of 2155 patients with incarcerated hernias of the anterior abdominal wall. Pyo-septic complications took place in 24.3%. A comparison of results of treatment by traditional methods with those using solution of sodium hypochlorite (indirect electrochemical oxidation of blood) has shown that in the group of patient treated with sodium hypochlorite lethality was reduced from (18.8 +/- 0.2)% to (11.2 +/- 0.2)%, the amount of suppuration of the operative wound was 1.8 times less and the average number of bed-days was (4.5 +/- 0.2) less.

Topics: Disinfectants; Female; Hernia; Herniorrhaphy; Humans; Infant, Newborn; Infusions, Intravenous; Male; Peritonitis; Postoperative Care; Postoperative Complications; Recurrence; Sepsis; Sodium Hypochlorite; Solutions; Time Factors

One hundred one continuous ambulatory peritoneal dialysis (CAPD) patients from a single North American center were analyzed in a retrospective and cross-over study for peritonitis rates using a standard system (Travenol System II) or a Y-shaped disconnect-disinfectant system (Travenol O-set). Twenty-one of 34 patients using the standard set (group I) had 53 episodes of peritonitis in 508 patient-months or one episode per 9.6 patient-months. Nine of 17 patients switching from the standard to the disconnect-disinfectant system (group II) experienced 22 episodes of peritonitis in 275 patient-months or one episode per 12.5 patient-months on the standard set, while six patients had 10 episodes of peritonitis in 275 patient-months or one episode per 27.5 patient-months on the disconnect-disinfectant system (P less than 0.04). Twenty-eight of 67 new CAPD patients starting on the disconnect-disinfectant system (group III) had 37 episodes of peritonitis in 1,086 patient-months or one episode per 29.4 patient-months (P less than 0.01 v group I). Exit-site infections (ESI) occurred in 35.3% of patients using the standard set versus 34.3% of those using the O-set. The presence of an ESI was not associated with a higher risk of peritonitis, but modified the bacteriological profile of subsequent peritonitis episodes in patients using the O-set, favoring the organisms isolated from the exit site. Decreases in peritonitis rates with the O-set were due to a reduction of peritonitis episodes secondary to most bacterial agents and not only to skin organisms. Diabetics using intraperitoneal insulin had similar peritonitis and ESI rates as nondiabetics.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Disinfectants; Female; Humans; Infections; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Quebec; Retrospective Studies; Sodium Hypochlorite

A controlled study in two centres compared the efficacy of the standard continuous ambulatory peritoneal dialysis (CAPD) system with that of a new method consisting of a Y-shaped set filled with sodium hypochlorite during the dwelling time. 62 new CAPD patients were randomly allocated to the standard method (group A: 30 patients; age 55.5 +/- 17.5 years) or to the Y-system (group B: 32 patients; age 55.1 +/- 14.3 years). In group A, there were 31 peritonitis episodes in 17 patients (57%) during a cumulative period of 351 months--1 episode every 11.3 patient-months. In group B, there were 11 peritonitis episodes in 10 patients (31%) during 363 months--1 episode every 33 patient-months. Life-table analysis showed a significant difference between the incidence of peritonitis in the two groups. The Y-system method is simple and economical and the frequency and the severity of side-effects appears to be acceptable.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Disinfectants; Female; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Prospective Studies; Random Allocation; Sodium Hypochlorite

To compare the efficacy of the standard Oreopoulos CAPD system with that of a new method consisting of a Y-shaped set filled with sodium hypochlorite during the dwelling time, a randomised controlled study was performed in 62 new CAPD patients. Life table analysis showed a significantly (p less than 0.001) less frequent incidence of peritonitis in the group treated with the Y connector system. This study shows that the Y system appears to be effective in reducing the incidence of peritonitis, as compared with the standard technique, in patients on the CAPD programme. The method is simple and economical and the incidence and the severity of side effects appear to be acceptable.

Topics: Adolescent; Adult; Aged; Child; Clinical Trials as Topic; Disinfection; Female; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Sodium Hypochlorite

An analysis of complex examination and results of treatment was made in 290 patients with diffuse peritonitis. The patients were divided into two groups according to way of sanation of the abdominal cavity. The sanation with 0.03% aqueous solution of sodium hypochlorite was used for the first group of 155 patients. The immobilized forms of sodium hypochlorite in carboxymethyl cellulose gel were applied in the second group. The rate of postoperative complications was decreased on 15.4%, the lethality--on 8.2% in the case of application of the immobilized forms of sodium hypochlorite. The developed technology allowed increasing of physical component of life quality of the patients in 1.3 times, though it didn't influence on psychical component.

Topics: Abdominal Cavity; Carboxymethylcellulose Sodium; Comparative Effectiveness Research; Disinfectants; Drainage; Drug Carriers; Female; Gels; Humans; Male; Middle Aged; Peritoneal Lavage; Peritonitis; Postoperative Complications; Quality of Life; Severity of Illness Index; Sodium Hypochlorite; Survival Analysis; Tissue Adhesions; Treatment Outcome

The treatment results of 109 patients with the disseminated septic peritonitis were analyzed. All patients were divided in two statistically similar groups. The first group of patients was treated using the standart approach (open surgery, eliminating the cause of peritonitis followed by further endoscopic planned sanations of the abdominal cavity). Difference of the treatment approach among the patients of the second group (n=41) was in using the pulsing stream of anticeptic for fibrine onlays elimination and the use of 200 ml of immobilized form of sodium hypochlorite gel for the final sanation. The treatment results among these patients were significantly better (the endotoxicosis parameters were 1.5 times lower and the recovery of motor intestinal function was 2 times faster). The morbidity level was 9% lower and the lethality level was 4% lower in comparison with patients of the 1st group.

Topics: Abdominal Cavity; Adolescent; Adult; Aged; Disinfectants; Female; Gels; Humans; Laparotomy; Male; Middle Aged; Peritoneal Lavage; Peritonitis; Severity of Illness Index; Sodium Hypochlorite; Treatment Outcome; Video-Assisted Surgery

The 1st group consisted of 68 patients with the diffuse peritonitis, who were treated with the use of traditional approach, i.e., laparotomy, elimination of the peritonitis source, nasointestinal intubation, abdominal cavity sanation and drainage. Within 24--48 hours all these patients had videoendoscopic abdominal sanation with the injection of 200 ml 0.03% water solution of sodium hypochlorite. The 2nd group, consisted of 41 patients. The first treatment stage was the same, but during the videoendoscopic stage the pulsing stream of the antiseptic was used and the procedure ended with intraabdominal injection of 200 ml 0.03% water solution of sodium hypochlorite immobilized in gel. All patients of the 2nd group showed better recovery results.

Topics: Abdominal Cavity; Adult; Aged; Anti-Infective Agents, Local; Drainage; Female; Humans; Laparotomy; Male; Middle Aged; Peritoneal Lavage; Peritonitis; Postoperative Complications; Retrospective Studies; Sodium Hypochlorite; Suppuration; Tissue Adhesions; Treatment Outcome; Video-Assisted Surgery

The goal of research is learning the change dynamic of "mature" fibrin in ridneys parenchyma in treatment of experimental bilious peritonitis with sodium hypochlorite. The work was made on 31 mongrel dogs, which were divided into two groups: control and experimental. It was revealed on with 24-hours experimental bilious peritonitis the presence of hyaline cylinders in the lumen of glomerular capillaries, which give a positive reaction to the "mature" fibrin. On the 3rd day of treatment with sodium hypochlorite in kidneys was revealed "mature" fibrin mostly extravascular localization with the significant decrease both the average size of "mature" fibrin and its volume fraction, which completely disappeared. what was the evidence of the arresting of hemocoagulation disorders under the influence of sodium hypochlorite.

Topics: Animals; Blood Coagulation Disorders; Disease Models, Animal; Dogs; Fibrin; Kidney Glomerulus; Male; Oxidants; Peritonitis; Sodium Hypochlorite

Complex examination and the following treatment of 380 patients with diffuse purulent peritonitis were analyzed. The patients were divided into 2 groups. The first group included 245 patients to whom the sanitization of the abdominal cavity used traditional antiseptics. The main group included 135 patients to whom the immobilized form of sodium hypochlorite in the carboxymethyl cellulose was introduced instead of aqueous solution. An original method of sanitization of the abdominal cavity allows 1.2-1.5 times decreased degree of endotoxicosis, 2-2.5 times improved the motor-evacuatory function of the intestine in different forms of treatment of peritonitis. In the main group of patients the number of postoperative complications was 10% less, lethality was 8.2% less.

Topics: Abdominal Cavity; Anti-Infective Agents, Local; APACHE; Carboxymethylcellulose Sodium; Combined Modality Therapy; Drug Carriers; Drug Delivery Systems; Female; Gastrointestinal Motility; Humans; Male; Peritonitis; Postoperative Complications; Sodium Hypochlorite; Suppuration; Surgical Procedures, Operative; Treatment Outcome

Topics: Administration, Topical; Adolescent; Anti-Bacterial Agents; Antibiotic Prophylaxis; Catheter-Related Infections; Catheters, Indwelling; Child; Disinfectants; Humans; Kidney Failure, Chronic; Mupirocin; Peritoneal Dialysis; Peritonitis; Pseudomonas Infections; Risk Factors; Skin Care; Sodium Hypochlorite; Staphylococcal Infections; Treatment Outcome

Peritoneal dialysis (PD) is a common maintenance renal replacement modality for children with ESRD frequently compromised by infectious peritonitis and catheter exit site and tunnel infections (ESI/TI). The effect of topical mupirocin (Mup) and sodium hypochlorite (NaOCl) solution was evaluated as part of routine daily exit site care on peritonitis and ESI/TI rates, causative microorganisms, and catheter survival rates.. Retrospective chart review of children on home continuous cycling PD between April 1, 2001 and June 30, 2007 was performed. Infection rates were examined based on exit site protocol used in two different periods: Mup alone, April 1, 2001 to November 17, 2004; and Mup and NaOCl (Mup+NaOCl), November 18, 2004 to June 30, 2007.. Eighty-three patients (mean PD initiation age: 12.1 +/- 5.8 yr) received home PD over 2009 patient months. Annualized rates (ARs) for peritonitis decreased from 1.2 in the Mup period to 0.26 in the Mup+NaOCl period (P < 0.0001). ARs for ESI/TI decreased from 1.36 in the Mup period to 0.33 in the Mup+NaOCl period (P < 0.0001). No infections with Mup-resistant organisms were observed when either Mup or Mup+NaOCl was used for prophylaxis. Gram-negative-organism associated peritonitis decreased from an AR of 0.31 in the Mup period to 0.07 in the Mup+NaOCl period (P < 0.001). Infection-related catheter removal rates decreased from 1 in 38.9 catheter-months in the Mup period to 1 in 94.2 in the Mup+NaOCl period (P = 0.01). Catheter survival rates were longer in the Mup+NaOCl period (Kaplan-Meier, P < 0.009).. The combination Mup+NaOCl in daily exit site care was very effective to reduce PD catheter-associated infections and prolong catheter survival in pediatric patients.

Topics: Administration, Topical; Adolescent; Anti-Bacterial Agents; Catheterization; Child; Disinfectants; Drug Therapy, Combination; Female; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic; Male; Mupirocin; Peritoneal Dialysis; Peritonitis; Pseudomonas Infections; Retrospective Studies; Skin Care; Sodium Hypochlorite; Staphylococcal Infections; Treatment Outcome

56 patients with disseminated purulent peritonitis were observed. All patients were divided into 2 groups. 30 patients treated according to traditional technique formed the first group. Surgical treatment included: laparotomy, elimination of the underlying condition that caused peritonitis, nasointestinal intubation of small intestine, abdominal cavity sanation with 0.02% furacillin solution till pure liquid, drainage. 200 ml of 0.03% aqueous solution of sodium hypochlorite was infused into abdominal cavity before closure. 26 patients treated according to the similar technique formed the second group. In contrast to the first group, 200 ml of immobilized form of sodium hypochlorite in carboxymetilcellulose gel was infused to the patients from the second group before wound closure. In early postoperative period the indices of endotoxicosis were in 1.6 times lower in patients from the second group and motor-evacuatory function of the stomach--twice higher compared with the patients from the first group. It decreased the amount of complications in 2 times, and postoperative lethality--in 2.6 times. In long-term postoperative period perfect treatment results increased in 20.8%, well--in 4.1%, tolerable--decreased in 20.9% compared with the results in the control group.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carboxymethylcellulose Sodium; Disinfectants; Drainage; Drug Combinations; Female; Follow-Up Studies; Gels; Humans; Infusions, Parenteral; Laparotomy; Male; Middle Aged; Peritonitis; Sodium Hypochlorite; Treatment Outcome; Young Adult

Presented are the results of experimental research on 144 animals (the rats Wistar), on whom was carried out resection of a part of large intestine and a intestinal anastamosis was formed in the presents of acute intestinal obstruction and peritonitis. The sanitation of abdominal cavity in the basic group of animals (74) was performed using sodium hypochlorite solution and dissolved ozone. The intestinal lavage was carried out by dissolved ozone with the subsequent introduction of ozonized oil Ozonide in the area of intestinal anastamosis. The combined application of ozone and sodium produces an expressed samative effect which leads to healing of intestinal anastamosis and decreases unstability of intestinal sutures and mortality.

Topics: Abdominal Cavity; Acute Disease; Animals; Disease Models, Animal; Intestinal Obstruction; Oxidants, Photochemical; Ozone; Peritonitis; Rats; Rats, Wistar; Remission Induction; Sodium Hypochlorite

Experimental (200 experiments) and clinical (in 46 patients) investigations have shown that immobilized forms of sodium hypocloride in methylcellulose gel makes the lethality level 1.9 times lower and the formation of abdominal adhesions 1.8 times less in experimental peritonitis. In patients with diffuse peritonitis this form restores the propulsive ability of the intestinal tube 2 times quicker and makes lethality 2.7 times less.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Disease Models, Animal; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oxidants; Peritoneal Lavage; Peritonitis; Rats; Rats, Wistar; Sodium Hypochlorite; Treatment Outcome; Young Adult

The 'Y' set introduced in the clinical practice in the early 80s with the aim of reducing the peritonitis rate in patients on continuous ambulatory peritoneal dialysis, successfully revolutioned the philosophy of the connection system catheter-container of dialysate, which was the main way of bacterial contamination of the peritoneal cavity. In fact, while the previous connection systems had focused the attention on the reduction of the possible contaminating acts, the 'Y' system, taking into account the fact that soon or later a failure could occur even with the most skilled and compliant patient, introduced the possibility to kill the bacteria with a disinfectant and to remove it and the killed bacteria together with the bacteria eventually still surviving, by flushing the contaminated area. This goal was achieved thanks to a 'Y' shaped connector, having a third way connected to the discharge bag/container, besides the two connected to the new bag and to the catheter. From the 'Y' set have originated all the currently used continuous ambulatory peritoneal dialysis connection systems, where the 'Y' is mounted on the bag side (double-bag systems). However in these systems the disinfectant is no longer used, due to the fear of possible untoward effects on the peritoneal membrane. The groundlessness of this position and the possible further advantages of the use of a disinfectant in combination with the 'Y' are discussed and new 'Y' systems preventing every possibility of accidental entry of disinfectant into the peritoneal cavity are presented.

Topics: Bacterial Infections; Catheters, Indwelling; Disinfectants; Equipment Contamination; Equipment Design; Humans; Infection Control; Kidney Failure, Chronic; Morbidity; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Risk Factors; Sodium Hypochlorite; Surgical Instruments; Uremia

Peritoneal catheter exit-site and tunnel infections remain critical problems in patients undergoing peritoneal dialysis. Catheter-related peritonitis occurs in about 20% of patients and exit-site infections are responsible for catheter removal in more than one-fifth of the cases. For the last 2 years in the Department of Nephrology, San Bortolo Hospital, Vicenza, Italy, we have been treating exit-site infections caused by Pseudomonas with sodium hypochlorite packs as well as systemic and local antibiotic therapy. Considering the encouraging results obtained on Pseudomonas infection, we decided to utilize the same schedule for the treatment of exit-site infections caused by other germs which are generally difficult to eradicate to prevent peritonitis and catheter removal. Between 2003 and 2004, 10 patients contracted infection of the exit-site. All patients underwent a swab test because of the reddening and the purulent secretion of the exit-site. The swab resulted positive for Pseudomonas in 7 patients, Corynebacterium sp. in 2 patients, and Candida albicans in 1 patient. All patients were treated with systemic antibiotic therapy or antifungal therapy, local sodium hypochlorite 50% packs. After 15 days all patients were submitted to a swab test of the exit site. In all patients, the swab test resulted negative after 15 days and 1 month, and they could continue peritoneal dialysis. This procedure avoided peritoneal catheter removal and temporary switch to hemodialysis in all patients with exit site infection. The mechanism of action is related to the wide antimicrobial spectrum and the rapid action of sodium hypochlorite possibly creating a protective barrier on the exit-site.

Topics: Anti-Bacterial Agents; Catheters, Indwelling; Cilastatin; Cross Infection; Disinfectants; Drug Therapy, Combination; Humans; Imipenem; Infection Control; Kidney Failure, Chronic; Peritoneal Dialysis; Peritonitis; Pseudomonas Infections; Sodium Hypochlorite

Continuous ambulatory peritoneal dialysis is the first-choice treatment for ESRD in Mexico. Peritonitis is the most frequent cause of morbidity and is among the leading causes of technique failure in our country. Our objective was to compare the efficacy of the standard and double-bag disconnect systems for the prevention of peritonitis in a high-risk population with poor living standards, and high prevalence of malnutrition and diabetes rates.. Episodes of peritonitis registered between July 1989 and June 2003 were included. Patients were divided in conventional and double-bag groups. Between July 1989 and May 1999, all patients used the conventional system. From May 1999, all incident patients were placed on a double-bag disconnect system.. Six-hundred and forty-seven patients started dialysis in the study period, 383 in the conventional group, and 264 in the double-bag. The peritonitis rate observed was 1 episode per 7.2 patient-months in the conventional group, and 1 episode per 25.1 patient-months in the double-bag system (p < 0.001). Cumulative peritonitis-free survival rate at 6 (50 vs. 82%), 12 (27 vs. 69%) and 24 (12 vs. 45%) months, respectively, was significantly lower in the conventional group (p < 0.001). Technique survival at 1 (75 vs. 85%), 2 (68 vs. 80%), and 3 years (50 vs. 80%), was worse in the conventional group (p < 0.001). By multivariate analysis, the only factor associated with peritonitis was the connecting system.. We conclude that switching from a standard to a double-bag system using electrolytically produced sodium hypochlorite disinfectant markedly decreased the peritonitis rate, even in a high-risk population like ours.

Topics: Adult; Disinfectants; Female; Humans; Incidence; Infection Control; Kaplan-Meier Estimate; Kidney Failure, Chronic; Male; Mexico; Middle Aged; Multivariate Analysis; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Prevalence; Retrospective Studies; Risk Factors; Sodium Hypochlorite; Vulnerable Populations

Combined postoperation treatment with sodium hypochlorite and alpha-tocopherol broke the chain of free radical reactions in lipids and promoted normalization of LPO processes in the plasma and erythrocytes of 250 rats with experimental bile peritonitis.

Topics: alpha-Tocopherol; Animals; Antioxidants; Bile; Lipid Peroxidation; Male; Peritonitis; Rats; Reactive Oxygen Species; Sodium Hypochlorite

We compared the normalizing effects of various methods of hemocorrection on homeostasis in animals with bile peritonitis. Combined treatment with hypochlorite and UV irradiation produced a potent membrane-stabilizing effect and increased adaptability of erythropoiesis.

Topics: Animals; Bile; Cell Membrane; Dogs; Homeostasis; Humans; Lipids; Male; Oxidants; Peritonitis; Proteins; Sodium Hypochlorite; Ultraviolet Rays; Ultraviolet Therapy; Water-Electrolyte Balance

Combined use of sodium hypochlorite and intravenous laser irradiation of the blood in the postoperation therapy of 24-h bile peritonitis improved recovery of engulfing and digestive activity of neutrophilic granulocytes in the early postoperation period. Enzyme activity of neutrophilic granulocytes in earlier postoperation periods returned to normal after treatment with sodium hypochlorite alone.

Topics: Animals; Bile; Blood; Combined Modality Therapy; Dogs; Laser Therapy; Neutrophils; Nitroblue Tetrazolium; Peritonitis; Peroxidase; Phagocytosis; Sodium Hypochlorite

Since the bacterial ability to develop resistance against various factors of their surroundings is a well-known phenomenon, resistance against iodine and specifically against povidone-iodine (PVP-I) has been widely investigated. Yet there is little known about bacterial resistance in long-term daily use of disinfectants in continuous ambulatory peritoneal dialysis (CAPD) patients. The aim of our study was to investigate whether on daily use of PVP-I over a period of at least 6 months coagulase-negative staphylococci (CNS)--the predominant infective organisms of peritonitis--developed resistance against PVP-I. At the catheter exit site of 40 CAPD patients we isolated 36 CNS. 23 CNS (CNS + PVP) orginate from patients using PVP-I, 13 CNS (CNS + CI) from patients using sodium hypochlorite (NaOCl) as disinfectant. The strains were biotyped, antibiotic resistance patterns were determined and resistance against PVP-I or NaOCl was calculated as reduction factor using the quantitative suspension test combined with a turbidimetric standardization. Resistance against PVP-I 0.01% and against NaOCl 0.005% was determined at two contact times (30 and 300 s) for each patient group. In addition, we investigated the effects of plasmid loss on sensitivity to PVP-I. Out of 5 multiple-antibiotic-resistant CNS, 3 strains showed no difference in reduction factor against PVP-I before and after curing. There was no significant difference in reduction factor against NaOCl. CNS + PVP were even significantly more sensitive to PVP-I than CNS + Cl. Taken together, our results demonstrate that long-term use of PVP-I does not cause any bacterial resistance in CNS of CAPD patients.

Topics: Anti-Infective Agents, Local; Bacterial Typing Techniques; Catheters, Indwelling; Colony Count, Microbial; Disinfectants; Drug Resistance, Microbial; Female; Humans; Iodophors; Male; Nephelometry and Turbidimetry; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Plasmids; Povidone-Iodine; Sodium Hypochlorite; Staphylococcal Infections; Staphylococcus; Time Factors

Topics: Combined Modality Therapy; Humans; Laparotomy; Peritoneal Lavage; Peritonitis; Pulmonary Embolism; Sodium Hypochlorite

The authors examined 48 patients with peritonitis (20 with the generalized and 28 with the localized form). The content of T-lymphocytes, theophylline-resistant and theophylline-sensitive T-lymphocytes, leukocyte chemotaxic activity, and the lymphocyte ATP content were studied. It was found that the state of the immune system in the early postoperative period allows the severity of the disease and its outcome to be prognosticated. A sharp decrease in the T-lymphocyte content and decrease of the amount of ATP in the lymphocytes in stable reduction of chemotaxic activity is an unfavorable prognostic sign. Introduction of indirect electrochemical oxidation with a sodium hypochlorite solution into the complex of intensive therapy produces, in addition to a marked detoxification effect, a stabilizing effect on metabolic processes in the lymphocytes and activates the cellular link of immunity. Combined immunocorrection with the agents tactivin and leukinferon possesses a high potential of an immunobiological effect and can be recommended for correction of severe secondary immunodeficiency in patients with generalized peritonitis.

Topics: Adenosine Triphosphate; Adjuvants, Immunologic; Chemotaxis, Leukocyte; Combined Modality Therapy; Cytokines; Drug Combinations; Humans; Interferon Type I; Peptides; Peritonitis; Postoperative Care; Prognosis; Severity of Illness Index; Sodium Hypochlorite; Sorption Detoxification; T-Lymphocytes; Thymus Extracts

The method of indirect electrochemical detoxification by means of sodium hypochlorite (NaClO) obtained by isotonic NaCl solution electrolysis on a [symbol: see text] device consists in modeling hepatic monooxygenase detoxifying function on cytochrome B-450. Indirect electrochemical detoxification was conducted in more than 200 patients with generalized abdominal pyo-inflammatory processes and marked intoxication syndrome. Sodium hypochlorite was used for intravenous treatment of endotoxicosis in concentrations of 600 mg/l and 300 mg/l in volumes of 1/10 and 1/6 CBV in patients with generalized fibrinopurulent peritonitis and pancreonecrosis and for local administration during programmed prophylactic treatment of the abdominal cavity. The detoxifying effect was best in patients with grade 2-3-intoxication (according to V. K. Gostishchev et al., 1989). Local use of NaClO was marked by a high necrolytic effect, antiseptic properties, capability for reducing the resistance of the microflora to antibiotics, etc. The work discusses the methods of hypochlorite application, indications, contraindications, possible complications and their prevention.

Topics: Adult; Aged; Combined Modality Therapy; Electrolysis; General Surgery; Humans; Infusions, Intravenous; Middle Aged; Necrosis; Pancreatic Diseases; Peritonitis; Sodium Hypochlorite; Sorption Detoxification; Suppuration

Sodium hypochlorite, administrated intravenously and intraperitoneally, leads to normal oxygen balance, metabolism and motility of small intestine in peritonitis. Anti-hypoxia effect of this substance is realized by an increase of oxygen content in the blood. It is useful to use sodium hypochlorite in general peritonitis for antibacterial therapy and against tissue hypoxia without side effects.

Topics: Animals; Gastrointestinal Motility; Intestine, Small; Oxygen; Oxygen Consumption; Peritonitis; Rats; Sodium Hypochlorite

Hemagglutinating antibodies and cell-mediated immunity are increased when antigens are injected intraperitoneally (i.p.) into rats during the healing phase of a chemical peritonitis. In the present work, the anaphylactogenic effects of either sensitization or challenge were increased when any of three different antigens were injected i.p. in the postinflammatory state. The postinflammatory state made it possible to sensitize rats for anaphylaxis without any adjuvants at all. Lymph nodes draining the peritoneal cavity had evidence of enhanced absorption of inoculum in the postinflammatory state.

Topics: Adrenal Glands; Aluminum Hydroxide; Anaphylaxis; Animals; Antibody Formation; Caseins; Dose-Response Relationship, Immunologic; Hemagglutination; Immunity, Cellular; Immunization; Immunoglobulin G; Injections, Intraperitoneal; Lymph Nodes; Male; Peritonitis; Pertussis Vaccine; Rats; Rats, Inbred Lew; Sodium Hypochlorite

Cell suspensions of chemically induced tumors (rhabdomyosarcoma) were transplanted into the peritoneal cavities of Lewis rats. In normal animals, the greater omentum was the main site of tumor growth, and transdiaphragmatic metastases to regional lymph nodes in the mediastinum were few and small. In animals during the healing phase of a chemical peritonitis, the greater omentum was fibrotic, shrunken, and inactivated. The loss of the scavenging function of the omentum was associated with wide dissemination of the tumor in the peritoneal cavity and increased access of the tumor to the lymphatic stomata on the peritoneal surface of the diaphragm. Number and size of transdiaphragmatic metastases in draining lymph nodes were greatly increased in this postinflammatory state.

Topics: Animals; Female; Fibrosis; Liver; Lymph Nodes; Lymphatic Metastasis; Mesentery; Neoplasm Metastasis; Neoplasm Transplantation; Omentum; Peritoneal Cavity; Peritoneal Neoplasms; Peritonitis; Rats; Rats, Inbred Lew; Rhabdomyosarcoma; Sodium Hypochlorite; Spleen; Tumor Cells, Cultured

Disadvantages of continuous ambulatory peritoneal dialysis (CAPD), such as inconvenience and bulkiness of the apparatus, inflexibility of infusion volume, and predictable peritonitis incidence may be altered by using systems which allow disconnection from the tubing and bag after each exchange. At University of Michigan we have followed 35 patients using the O set with sodium hypochlorite (Baxter Healthcare Corp.) for 15.5 +/- 10 months, 16 patients using the Y configuration Ultraset (Baxter Healthcare Corp.) for 8.1 +/- 5 months, and 6 patients using a universal adapter (Delmed Corp.) for 14.3 +/- 7 months. Failure occurred in 7 cases (18%) at 12 +/- 8 months using the O set (3 elective, 3 related to peritonitis, 1 ultrafiltration difficulty), and 1 (7%) at 3 months using the Ultraset (related to peritonitis). Accidental sodium hypochlorite infusion occurred 8 times in 6 patients, 4 patients still on CAPD without residual effect and 2 in whom infusion contributed to failure but not to ultrafiltration difficulty. Cumulative per-patient-year (episode/months) peritonitis rates of 0.75 (1/16.4), 0.65 (1/18.4) and 0.88 (1/14.3), respectively, compare favorably with the overall center experience of 0.96 (1/12.2) (NIH-CAPD Registry). Peritonitis rates did not differ during use of any of the disconnect systems between patients with prior CAPD experience compared to patients without prior CAPD experience.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Bacterial Infections; Catheters, Indwelling; Evaluation Studies as Topic; Female; Humans; Kidney Failure, Chronic; Male; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Retrospective Studies; Sodium Hypochlorite

During the healing phase of a chemical peritonitis in rats, absorption of various inocula from the peritoneal cavity into the draining lymph nodes is increased. Heretofore, this phenomenon has been attributed to fibrosis and shrinkage of the greater omentum. The loss of the sequestering function of the omentum allows the inoculum more ready access to the lymphatic vessels in the diaphragm where it is absorbed. In the present work, it is demonstrated that the chemical peritonitis also widens the stomata in the roofs of the diaphragmatic lymphatic lacunes. Both increased access and larger openings contribute to enhanced lymphatic absorption in the postinflammatory state.

Topics: Absorption; Animals; Ascitic Fluid; Carbon; Coloring Agents; Diaphragm; Female; Fibrosis; Inflammation; Lymphatic System; Male; Omentum; Peritonitis; Rats; Rats, Inbred Lew; Sodium Hypochlorite

One week after intraperitoneal injection of rats and mice with a chemical irritant, the abdominal cavity was in the healing phase of a sterile peritonitis. At this time, mineral oil or a particulate dye or metal injected intraperitoneally was absorbed into lymph nodes in much larger amounts than normal. Absorption of oil caused fourfold enlargement of nodes, distention of afferent lymphatics, and sometimes widespread oil embolization of lungs. Absorption was increased when the chemical irritant had bathed the entire peritoneum but not when it was limited to the lower abdominal cavity. The chemical peritonitis caused shrinkage, agglutination, fixation, and fibrosis of the greater omentum which thereby lost its ability to sequester particles. In the absence of omental scavenging, dye, metal, or oil accumulated under the diaphragm and penetrated the diaphragmatic lymphatics. In addition, enhanced absorption by proliferated subdiaphragmatic lymphatics may have been involved. Prior induction of a chemical peritonitis augments absorption into the lymphatics of certain aqueous and cellular as well as particulate and oily inocula, so it is likely to find many applications in experimental pathology.

Topics: Absorption; Animals; Female; Lymph Nodes; Male; Oils; Peritonitis; Rats; Rats, Inbred Lew; Sodium Hypochlorite; Structure-Activity Relationship