Emergency Surgery Comparative Study of Saline Solution (SS) versus Stabilized Isotonic Sodium Hypochlorite Solution (SISHS) in Peritoneal Lavage in Open Appendectomy to Prevent Complications of Complicated Appendicitis in 120 Adults from México

Abstract There is no clear consensus on whether peritoneal lavage should be used or not, nor which solution is ideal to use, this research focused on evaluating the outcomes of using two different types of solutions and protocols for intraperitoneal lavage in adult patients diagnosed with complicated appendicitis. The sample (n=120) was divided into two groups: Saline Solution (SS) Group (n=60) which uses 2,000 mL irrigation for 3-5 minutes with subsequent excess elimination and Stabilized Isotonic Sodium Hypochlorite Solution (SISHS) Group (n=60) which uses 443 mL irrigation for 2 minutes with subsequent suction. After performing the surgical procedure of open appendectomy, the postoperative hospital stay (total days) was evaluated along with rates of the complications (frequency and percentage) occurring within one month (30 days) after surgery. At the end the total cost of treatment was calculated for each group. Regarding postoperative hospital stay, the SISHS group required only 1.86 ± 0.6 days versus the 6.15 ± 5.59 days required by the SS group, with a statistically significant difference (p = 0.004), concerning to adverse events at 30 days, these were generally less frequent with statistically significant differences (p = 0.01 to p = 0.002) in the SISHS group compared to the SS group (with exception of hypothermia), finally the total treatment cost for the SISHS group was 42.8% cheaper compared to the SS group. These findings represent a promising therapeutic option, considering the favorable outcomes manifested by a shorter hospital stay, lower frequency of adverse events 1 month after surgery and total healthcare costs observed in the SISHS group.