TI:  Irrigation of the Abdominal Cavity in the Treatment of 
     Experimentally Induced Microbial Peritonitis: Efficacy of 
     Ozonated Saline

DT:  May 1993

AU:  Ozmen V., Thomas WO., Healy JT., Fish JM., Chambers R., 
     Tacchi E., Nichols RL., Flint LM., 	Ferrara JJ.  
     Department of Surgery, Tulane University School of Medicine, 
     New Orleans.
SO:  American Surgeon 59(5):297-303, 1993 May

AB:  Ozone is an oxidizing agent possessing potent in vitro 
     microbicidal capacity.  This study was designed to address 
     the extent to which irrigation of the contaminated abdominal 
     cavity using a saline solution primed with ozone is 
     effective in reducing morbidity and mortality.  Gelatin 
     capsules containing different quantities of a premixed 
     slurry of filtered human fecal material were implanted in 
     the peritoneal cavities of a preliminary series of rats.  
     Three inocula concentrations were selected for later 
     experiments, based upon their ability to produce morbid 
     consequences: (1) high (100% 1-day mortality), (2) medium 
     (70% 3-day mortality, 100% abscess rate in survivors), and 
     (3) low (100% 10-day survival, 100% abscess rate).  Fecal 
     and abscess bacteriology were similar in all rats.  The 
     peritoneal cavities of 240 rats then underwent fecal-capsule 
     implantation (three groups of 80 rats/inoculum 
     concentration).  At celiotomy 4 hours later, equal numbers 
     of rats from each group were randomly assigned to one of 
     four protocols: (1) no irrigation, (2) normal saline 
     irrigation, (3) saline-cephalothin irrigation, and (4) 
     ozonated saline irrigation.  Each treatment lasted 5 
     minutes, using 100 ml of irrigation fluid.  Mortality was 
     significantly reduced when, in lieu of no irrigation, any of 
     the irrigation solutions were used.  Additionally, ozonated 
     saline statistically proved the most effective irrigating 
     solution for reducing abscess formation in survivors.