title: Peritoneal lavage using chlorhexidine gluconate at the end of colon surgery reduces postoperative intra-abdominal infection in mice.
abstract: BACKGROUND
  The use of peritoneal lavage with antiseptic solutions after bowel surgery remains controversial. This study compared peritoneal lavage using chlorhexidine gluconate at low concentrations and normal saline in mice with cecal ligation and perforation.
  
  
  METHODS
  A total of 180 mice were randomized to six groups. Groups A, B, and C received one-time intraperitoneal injections of normal saline, chlorhexidine gluconate 0.05%, and chlorhexidine gluconate 0.025%, respectively. Groups D, E, and F were all subject to cecal ligation and perforation, then underwent partial cecectomy and peritoneal lavage with normal saline only, chlorhexidine gluconate 0.05% followed by normal saline, and chlorhexidine gluconate 0.025% followed by normal saline, respectively. Animals were followed postoperatively then sacrificed and examined at necropsy for occurrence of intra-abdominal abscesses, adhesions, or other pathology.
  
  
  RESULTS
  A total of 48 mice (26.7%) developed postoperative intra-abdominal abscesses. Group E mice that had chlorhexidine gluconate 0.05% lavage had significantly lower incidence of postoperative intra-abdominal abscesses compared with that of group D mice that had saline lavage only (P = 0.0113). There was no significant difference in occurrence of macroscopic adhesions among mice groups that had or did not have surgery. (P = 1 and P = 0.3728). Microscopic peritoneal fibrosis occurred significantly more among group E mice that had chlorhexidine gluconate 0.05% lavage compared with group D mice that had saline lavage only (P = <0.005). There was no significant difference in postoperative mortality between surgical groups (P = 0.8714).
  
  
  CONCLUSIONS
  Chlorhexidine gluconate 0.05% peritoneal lavage after partial colectomy (cecectomy) in mice reduces postoperative intra-abdominal infection without significant macroscopic adhesion formation.
authors: James H. Quillen Veterans Affairs Medical Center, and Department of Internal Medicine, Division of Infectious Diseases, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee. Electronic address: shams@etsu.edu.
authors: Wael E
authors: WE
authors: Shams
authors: Division of Laboratory Animal Resources, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
authors: Gregory A
authors: GA
authors: Hanley
authors: Department of Pathology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
authors: Andrea
authors: A
authors: Orvik
authors: Department of Mathematics and Statistics, College of Arts and Sciences, East Tennessee State University, Johnson City, Tennessee.
authors: Nicole
authors: N
authors: Lewis
authors: Department of Pathology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
authors: M Salah
authors: MS
authors: Shurbaji
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003082:Colectomy / Q000009:adverse effects*; D059413:Intraabdominal Infections / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008813:Mice, Inbred ICR; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011897:Random Allocation
chemical_list: D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: Chlorhexidine gluconate; Colon surgery; Lavage; Mice; Peritoneal