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.