• A Hecker, F Uhle, T Schwandner, W Padberg, and M A Weigand.
• Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany, Andreas.Hecker@chiru.med.uni-giessen.de.
• Langenbecks Arch Surg. 2014 Jan 1;399(1):11-22.

PurposeIn the perioperative phase, sepsis and sepsis-associated death are the most important problems for both the surgeon and the intensivist. Critically ill patients profit from an early identification and implementation of an interdisciplinary therapy. The purpose of this review on septic peritonitis is to give an update on the diagnosis and its evidence-based treatment.ResultsRapid diagnosis of sepsis is essential for patient´s survival. A bundle of studies was performed on early recognition and on new diagnostic tools for abdominal sepsis. Although surgical intervention is considered as an essential therapeutic step in sepsis therapy the time-point of source control is still controversially discussed in the literature. Furthermore, the Surviving Sepsis Campaign (SSC) guidelines were updated in 2012 to facilitate evidence-based medicine for septic patients.ConclusionDespite many efforts, the mortality of surgical septic patients remains unacceptably high. Permanent clinical education and further surgical trials are necessary to improve the outcome of critically ill patients.

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