Postoperative Lavage

In order to keep the catheters for drug instillation and abdominal drainage clear of blood clots and tissue debris, an abdominal lavage is begun in the operating room This lavage utilizes the same tubes and drains positioned for the heated intraoperative intraperitoneal chemotherapy. We have utilized large volumes of fluid, which are rapidly infused and then drained from the abdomen after a short dwell time. The standardized orders for immediate postoperative lavage are given in Table 6. All intraabdominal catheters are withdrawn before the patient is discharged from the hospital.

TABLE 6

Immediate postoperative abdominal lavage orders.

Day of Operation:

Run in 1000 ml of 1.5% dextrose peritoneal dialysis solution as rapidly as possible.
Warm to body temperature prior to instillation. Clamp all abdominal drains during infusion.
No dwell time.
Drain as rapidly as possible through the Tenckhoff catheter and abdominal drains.
Repeat irrigations every 1 hour for 4 hours, then every 4 hours until returns are clear;
then every 8 hours until chemotherapy begins.
Change dressing covering Tenckhoff catheter and abdominal drain sites using sterile technique once daily and prn.