Efficacy and safety of strong acid electrolyzed water for peritoneal lavage to prevent surgical site infection in patients with perforated appendicitis.
OBJECTIVE
Our previous experimental study of perforated peritonitis in rats proved that peritoneal lavage with strong acid electrolyzed water (SAEW) has no adverse effects, reduces the bacteria count in the ascitic fluid more effectively than saline, and increases the survival rate significantly. Thus, we conducted a randomized controlled study, applying SAEW in the treatment of perforated appendicitis in children.


METHODS
Forty-four patients, aged 3-14 years, were randomly divided into two groups: Group S (n = 20), in which the peritoneal cavity was lavaged with 100 ml/kg saline and the wound was washed out with 200 ml saline; and Group E (n = 24), in which the peritoneal cavity was lavaged with 100 ml/kg SAEW and the wound was washed out with 200 ml SAEW.


RESULTS
No adverse effect of SAEW was observed in Group E. There was no difference in the bacterial evanescence ratio of ascitic fluid after lavage between Groups S and E (11.1 and 15.8%, respectively). A residual abscess developed in one patient from each group (5.0 and 4.2%, respectively). The incidence of surgical site infection (SSI) was significantly lower in Group E than in Group S (0 and 20%, respectively; P < 0.05). There was no difference in the duration of pyrexia, positive C-reactive protein, leukocytosis, or hospital stay between the groups.


CONCLUSIONS
Peritoneal lavage and wound washing with SAEW have no adverse effects and are effective for preventing SSI.
Department of Pediatric Surgery, Osaka Medical Center and Research Center for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan, kubota@wakayama-med.ac.jp.
Akio
A
Kubota
Taro
T
Goda
Tomomitsu
T
Tsuru
Takeo
T
Yonekura
Makoto
M
Yagi
Hisayoshi
H
Kawahara
Akihiro
A
Yoneda
Yuko
Y
Tazuke
Gakuto
G
Tani
Tomohiro
T
Ishii
Satoshi
S
Umeda
Katsuhisa
K
Hirano
D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D010533:Peritoneal Lavage / Q000379:methods*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; C118085:superoxidized water; D006861:Hydrogen Peroxide