Jemds.com Original Article Journal of Evolution of Medical and Dental Sciences/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 4/ Issue 105/ Dec. 31, 2015 Page 16988 STUDY OF THE ROLE OF PER-OPERATIVE PERITONEAL LAVAGE WITH SUPER OXIDIZED SOLUTION IN PERFORATION PERITONITIS Rambabu Meena 1 , Bhagchand Khorwal 2 , Anju Meena 3 , Kuldeep Singh Yadav 4 1 Medical Officer, Department of General Surgery, CHC Mahwa, Dausa. 2 Medical Officer, Department of General Surgery, CHC Chomu, Jaipur. 3 Junior Resident, Department of Anaesthesia, Dr. S. N. Medical College, Jodhpur. 4 Junior Resident, Department of Psychiatry, MGM College, Jaipur. ABSTRACT BACKGROUND The fundamental in treatment of perforation peritonitis include resuscitation, treatment of septicemia, control of contaminating source and peritoneal toilet. Numerous studies have shown the role of different solutions such as normal saline, antibiotics and betadine as peritoneal lavage in reducing morbidity and mortality of perforation peritonitis. The objective of this study was to present our finding on the role of per-operative peritoneal lavage with super-oxidized solution in cases of perforation peritonitis and its effects on postoperative course and outcome compare to per operative lavage with saline. MATERIALS AND METHODS The patients were randomized into two groups. In the control group after the definitive surgery for perforation peritonitis, the peritoneal cavity was lavaged with normal saline and closed after putting drain. In study group after definitive surgery the peritoneal cavity was lavaged with saline followed by 100ml of super-oxidized solution and drain were closed for 1h after abdominal closure. The patients were followed up for morbidity and mortality. RESULT In present study, there was no statistically significance between super-oxidized solution and normal saline lavage group. When we compared it on the basis of postoperative wound infection, fever, burst abdomen and other complication, duration of hospital stay and morbidity and mortality. CONCLUSION By this study we concluded that peritoneal lavage by super-oxidized solution or normal saline alone did not make any difference on patient outcome. KEYWORDS Super-oxidized solution 1; normal saline 2; perforation peritonitis 3. HOW TO CITE THIS ARTICLE: Meena R, Khorwal B, Meena A, et al. “Study of the role of per-operative peritoneal lavage with super- oxidized solution in perforation peritonitis.” Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 105, December 31; Page: 16988-16990, DOI: 10.14260/jemds/2015/2566 INTRODUCTION Perforation peritonitis continues to be a serious problem and in severe instances the fatality rate may be as high as 33%. Clinical outcome may vary from fulminant toxemia to development of sepsis with single or multiple abscesses. The treatment of perforation peritonitis requires early and continuous efforts to control the bacterial factors, colloid changes, cellular and extracellular electrolytes and prevention of respiratory and cardiac failure. In severe peritonitis, the use of exploratory laparotomy and intraoperative lavage with large amount of saline solution has been the standard of care to reduce risk of postoperative infection. The instillation of crystalloid solutions into the peritoneal cavity during the laparotomy is a routine practice of many surgeons. 1 Financial or Other, Competing Interest: None. Submission 05-12-2015, Peer Review 07-12-2015, Acceptance 18-12-2015, Published 29-12-2015. Corresponding Author: Dr. Rambabu Meena, S/o. Raju Lal Meena, Vill Ishrikhera Post, Rindli Tel, Mahwa Dist., Dausa Raj-321608. E-mail: rambabumeena25@gmail.com DOI:10.14260/jemds/2015/2566 A study by Ahrenholz has shown that irrigation with these solutions not only dilute bacterial mass, but also impair bacterial phagocytosis because of dilution of defensive proteins like opsonins. [1][2] Several other studies also support the idea that intraoperative irrigation with normal saline, in the absence of other antimicrobial substance, have no beneficial effect. [3,4,5] The role of antimicrobial agents such as kanamycin, metronidazole and povidone iodine in Intraoperative Peritoneal Lavage (IOPL) was proved to be non-effective by some authors. [5,6,7] Recently, some studies have recommended the use of super-oxidized solution with normal saline for irrigation in cases of intra-peritoneal sepsis that it has synergetic effect on patient outcome. [8,9,10,11,12,13] Super-oxidized solutions are neutral pH, hypotonic solutions with a controlled amount of reactive species and low chlorine content. Its antiseptic properties are due to its reactive species of oxygen and chlorine. These reactive species create an unbalanced osmolarity, so that it damages the integrity of the cell membrane, then react and denature the lipids and proteins of single cell organisms. This is because of a direct result of the osmolarity difference between the ion concentrations of the solution and single cell organisms.