title: Application of an electrolyzed strongly acidic aqueous solution before wound closure in colorectal surgery.
abstract: BACKGROUND
  Electrolyzed strongly acidic aqueous solution which is produced by electrolysis of a sodium chloride solution has been used in Japan for the irrigation of wounds or body cavities even in the absence of particular evidence.
  
  
  OBJECTIVE
  The purpose of this study is to investigate the efficacy or harmful effects of the disinfectant when applied before wound closure in colorectal surgery.
  
  
  METHODS
  We performed a prospective, randomized study.
  
  
  METHODS
  The study was conducted at Surgical Department of Hyogo College of Medicine
  
  
  METHODS
  Patients who underwent elective colorectal surgery were randomly assigned to 2 groups. The surgical wound was irrigated with >500 mL of the disinfectant or saline solution after the completion of fascia closure. Patients with dirty/infected wounds were excluded from the study.
  
  
  METHODS
  The primary end point of this study was comparison of the frequency of incisional surgical site infection. The secondary end point was the occurrence of wound dehiscence or wound hernia.
  
  
  RESULTS
  One hundred eighty patients in the disinfectant group and 183 patients in the saline solution group were analyzed. In multivariate analysis, IBD and contaminated wounds were independent risk factors for incisional surgical site infection. Application of the disinfectant tended to lower the risk of the infection (OR 0.457, 95% CI 0.206-1.013). In the analysis of poor wound healing, preoperative hospital stay of >2 weeks, stoma creation, and use of the disinfectant (OR 2.28, 95% CI 1.03-5.04) were independent risk factors.
  
  
  CONCLUSIONS
  This study was not a double-blind trial.
  
  
  CONCLUSIONS
  Application of electrolyzed strongly acidic aqueous solution to the wound impaired wound healing. Routine use of electrolyzed strongly acidic aqueous solution is not recommended in patients undergoing elective colorectal surgery. As for the contribution of the disinfectant to preventing wound infections, further study is needed to make a definitive conclusion.
authors.affiliation: Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. takesuey@hyo-med.ac.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ichiki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakajima
authors.forename: Toshie
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Motoi
authors.initials: M
authors.lastname: Uchino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeuchi
mesh_terms: D003108:Colonic Diseases / Q000601:surgery; D003107:Colorectal Surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: C118085:superoxidized water; D006861:Hydrogen Peroxide