TITLE:
Hypochlorous Acid for Septic Abdominal Processes Using a Unique Negative Pressure Wound Therapy System: A Pilot Study
AUTHORS:
Marc R. Matthews, Asia N. Quan, Anushi R. Shah, Carmen I. Tugulan, Beshoy A. Nashed, Ross F. Goldberg, Paola G. Pieri, Luis G. Fernandez, Areta Kowal-Vern, Kevin N. Foster
KEYWORDS:
AbtheraTM, Hypochlorous Acid, Negative Pressure Wound Therapy-Irrigation (NPWT-i), Septic Abdomen, Temporary Abdominal Closure (TAC), V.A.C. VeraFloTM, Vashe®
JOURNAL NAME:
Surgical Science,
Vol.9 No.11,
November
26,
2018
ABSTRACT: Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We hypothesized that Vashe®, a neutral hypochlorous acid solution (V-HOCL), would be safe as an intraperitoneal irrigation or washout disinfectant for septic open abdomens utilizing negative pressure wound therapy. Methods: This is a retrospective observational review of patients who required delayed abdominal closures after exploratory laparotomies. Group A (n = 8) had cyclical V-HOCL irrigation to their open abdomens combining AbtheraTM and V.A.C. Dressing System for negative pressure wound therapy with irrigation (NPWT-i) and Group B (n = 9) had intra-abdominal V-HOCL washouts. Results: Fifty percent of both groups had either septic or hemorrhagic shock on admission. Compared to Group B, Group A patients were older (median 50 vs 37 years), and had a median hospitalization of 28 vs 8 days, 4 times as many operations, more acute renal failure and co-morbidities. No statistically significant differences were detected be-tween the two treatment methods with the V-HOCL delivery and removal. Conclusion: There were no episodes of electrolyte imbalance, hypotension, hypertension, anaphylaxis, hemorrhage, visceral injury or systemic toxicity. V-HOCL with/without NPWT-i irrigation was a safe modality and tolerated well in this study.