Prophylactic saline peritoneal lavage in elective colorectal operations

Abstract

The influence of a single peroperative 5-l saline peritoneal lavage was assessed in 21 consecutive patients undergoing elective operation for colorectal cancer. Reduction in bacterial counts by saline lavage was investigated to determine whether it would reduce the incidence of infection and thereby avoid the need for prophylactic antimicrobials. Saline lavage significantly reduced the aerobic bacterial counts in the peritoneal fluid 2 .times. 104 to 5 .times. 101 (P < 0.001) and reduced the counts of anaerobes in peritoneal fluid from 8 .times. 104 to 1 .times. 102 (P < 0.001). Despite the profound reduction in peritoneal bacterial counts, the rate of postoperative sepsis was extremely high; wound infection 47%, intraabdominal abscess 26% and septicemia 13%. Saline peritoneal lavage alone is no substitute for short-term antimicrobial prophylaxis.