Effect of intraperitoneal hypochlorous acid (HOCl) on bacterial translocation in an experimental peritonitis model in rats.

BACKGROUND

This study compared the effects of saline, routinely used for intra-abdominal irrigation, with hypochlorous acid (HOCl), which we believe could be suitable for clinical practice in the future, on bacterial translocation in a rat model of peritonitis.

METHODS

Four groups were formed: Sham, Control, cecal ligation and puncture with saline (CLP+SF), and cecal ligation and puncture with hypochlorous acid (CLP+HA), with 11 rats in each group, for a total of 44 rats. One rat in the Control group died and was excluded from the study. The comparison focused on saline, which is routinely used for intra-abdominal irrigation, and HOCl, which is considered a potential option for future clinical use.

RESULTS

A statistically significant difference was observed between the CLP+SF and CLP+HA groups in liver, spleen, and mesenteric lymph node tissue cultures (p<0.001, p=0.004, and p=0.001, respectively). However, no significant difference was found between the CLP+SF and CLP+HA groups in blood cultures (p=0.181). Although bacterial growth in blood cultures was numerically lower in the CLP+HA group, the absence of statistical significance between the CLP+HA group and other groups was attributed to the limited sample size and the short duration of the experimental peritonitis/sepsis model. Additionally, enzyme-linked immunosorbent assay (ELISA) results from blood samples showed that the mean levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), both inflammatory markers, did not differ significantly among the groups. This indicates that HOCl significantly reduced bacterial translocation without suppressing the inflammatory response.

CONCLUSION

It is predicted that the widespread use of HOCl in clinical practice could reduce mortality and morbidity in cases of perforation-induced peritonitis of intra-abdominal sepsis, shorten hospital stays, lower the cost of medical treatment, and contribute to the national economy in the healthcare sector.