Intraabdominal Lavage of Hypochlorous Acid

A New Paradigm for the Septic and Open Abdomen

Luis G Fernández, MD, KHS, KCOEG, FACS, FASAS, FCCP, FCCM, FICS; Marc R. Matthews, MD, FACS; Lawton Seal, MS, PhD


Wounds. 2020;32(4):107-114. 

In This Article


Based on the results of this study, the authors believe instillation through the TAC device may be the next evolution in the use of abdominal NPWT and that programmed intermittent lavage of the peritoneal cavity represents an effective method in the care of patients with a septic OA. This revolutionary approach may potentially decrease the number of operative abdominal re-explorations and provide more effective intraperitoneal sepsis control by reducing the concentration of intraabdominal microbial pathogens and proinflammatory mediators. Based on this limited study, the authors conclude that intraabdominal NPWTi-d with HOCl was useful in the care of patients with a septic OA.

These 3 cases represent common clinical manifestations of the septic abdomen from a variety of sources and are illustrative of the types of general surgical patients who may benefit from this modified approach. This off-label adaptation of the TAC device and instillation system show this form of TAC can be used as a 2-way therapy with instilling HOCl as the intraabdominal lavage fluid. The lack of eukaryotic cellular toxicity and unique antibacterial, antifungal, and biofilm-disrupting properties in HOCl effectively inhibit the bacteria growth and biofilm development. The techniques used in this case series represent a potential paradigm shift in the management of the septic OA.