[Evaluation of therapeutic measures in toxicoseptic states]. / Evaluarea masurilor terapeutice în starile toxicoseptice.

Based on observations made in 112 cases of toxico-septic conditions that had developed in surgical and obstetrical conjunctures, the authors propose a unified codification of the major therapeutical means (etiologic therapy, general, non-specific and specific therapy, adapted for functions and organs). The removal, or surgical draining of the septic focus is the most efficient therapy of toxicoseptic conditions of surgical or obstetrical origin. Compared to this method all the other therapeutical methods are secondary or adjuvant. The authors have acquired a vast experience in the use of a device for peritoneal washing-draining in cases with toxico-septic syndrome of surgical and obstetrical origin. General, non-specific therapeutic measures for quantitative and qualitative maintenance of the internal environment of the organism are achieved with relatively large amounts of non-colloidal crystalloid isotonic solutions, administered over the entire duration of the toxico-septic condition. The importance of the specific therapy is stressed, adapted for functions and organs, stressing amost particularly the therapeutical measures in which the authors have acquired extensive experience.

[Atypical postoperative peritonitis]. / Peritonita atipica postoperatorie

In the present conditions of development of the medical sciences the wide and varied use of pre- and postoperative antibiotherapy, to which is added the complex therapy carried out in the intensive-care unit, have changed the course of the dramatic postoperative peritonitis that at present do not develop any more according to the classical symptomatology. The key to success in these cases is the discovery as rapidly as possible of the moment when peritoneal infection has started to develop in view of applying the only correct treatment--reintervention. The present study makes an analysis of 32 cases and stresses the atypical evolution of postoperative peritonitis: contracture, pain, high fever and hyperleukocytosis cannot be considered any more as constant and certain signs. Meteorism and gastric stasis that is prolonged or that developes after 4-8 days following surgery are the most frequently encountered of the signs and are considered to be the most important. Exploratory laparotomy is the most correct attitude in dubious cases.