Prophylactic saline peritoneal lavage in elective colorectal operations.

The influence of a single peroperative five-liter saline peritoneal lavage has been assessed in 21 consecutive patients undergoing elective operation for colorectal cancer. The aim of the study was to investigate whether reduction in bacterial counts by saline lavage would reduce the incidence of infection and thereby avoid the need for prophylactic antimicrobials. Saline lavage was shown to reduce significantly counts in peritoneal fluid of aerobic bacteria from 2 x 10(4) to 5 x 10(1) (P less than 0.001) and to reduce the counts of anaerobes in peritoneal fluid from 8 x 10(4) to 1 x 10(2) (P less than 0.001). Despite the profound reduction in peritoneal bacterial counts the rate of postoperative sepsis was extremely high; wound infection 47 per cent, intraabdominal abscess 26 per cent and septicemia 13 per cent. These results indicate that saline peritoneal lavage alone is no substitute for short-term antimicrobial prophylaxis.