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Hypochlorous Acid Solution Is Safe for Intracavitary Lavage: Examination in a Rodent Model
Robert L Ball1,2, Gaurav Garg1,2, Juan Sebastian Vazquez1,2
1Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC.
Background:
Intracavitary irrigation is a routine component of many surgical procedures, especially in those involving a contaminated field. Normal saline remains the irrigant of choice for most surgeons. Hypochlorous acid is a weak acid that produces hypochlorite ions with antimicrobial properties. Reducing microbial concentration during intracavitary irrigation is a potential benefit of using hypochlorous acid solution over normal saline. In this study, the safety of hypochlorous acid solution for intracavitary lavage was compared with normal saline in a rat model of 3 surgical procedures-laminectomy, thoracotomy, and laparotomy.
Methods:
The intracavitary space was lavaged with either normal saline or hypochlorous acid. The procedures were also completed using Dakin's solution (sodium hypochlorite) as a comparator, given its known cytotoxicity. On postoperative day 5, necropsies of all animals were performed and relevant organs and blood samples obtained. Histology (hematoxylin and eosin staining) was used to examine biopsies of the collected organs for signs of inflammation, blood vessel integrity, and necrosis. Immunohistochemistry staining for caspase-3 was used to identify apoptotic cells.
Results:
There were no differences in outcomes (survival, pain, and time to recovery) or histology between animals lavaged with hypochlorous acid and normal saline. Intact organ-specific architecture was observed in both groups. In comparison, rats treated with Dakin's solution demonstrated significant capsular fibrosis and hemorrhage. Furthermore, significant apoptosis was noted within the bowel mesentery of the group treated with Dakin's solution when stained for caspase-3.
Conclusion:
Hypochlorous acid is safe for lavage of intraperitoneal, intrathecal, and intrathoracic cavities. Further studies should be conducted to demonstrate efficacy of hypochlorous acid in an infected field.
Insights
Hypochlorous acid is safe for intracavitary lavage, showing no adverse effects compared to normal saline in surgical rat models. Dakin's solution, however, caused significant tissue damage and apoptosis.
Area of Science:
- Surgical Innovation
- Biomedical Research
- Antimicrobial Agents
Background:
- Intracavitary irrigation is standard in surgery, particularly in contaminated fields.
- Normal saline is the typical irrigant, but hypochlorous acid offers potential antimicrobial benefits.
- This study evaluates hypochlorous acid safety for intracavitary lavage versus normal saline.
Purpose of the Study:
- To compare the safety of hypochlorous acid solution with normal saline for intracavitary lavage.
- To assess the cytotoxic effects of hypochlorous acid and Dakin's solution in a rat surgical model.
Main Methods:
- Rats underwent laminectomy, thoracotomy, or laparotomy, followed by intracavitary lavage with normal saline or hypochlorous acid.
- Dakin's solution was used as a cytotoxic comparator.
- Histological examination and caspase-3 immunohistochemistry were performed on postoperative day 5.
Main Results:
- Hypochlorous acid lavage showed no significant difference in outcomes or histology compared to normal saline.
- Organ-specific architecture remained intact in both hypochlorous acid and normal saline groups.
- Dakin's solution induced significant fibrosis, hemorrhage, and apoptosis in the bowel mesentery.
Conclusions:
- Hypochlorous acid is a safe irrigant for intraperitoneal, intrathecal, and intrathoracic cavities.
- Further research is needed to establish the efficacy of hypochlorous acid in infected surgical fields.
