Comment on: Effect of peritoneal and wound lavage with super-oxidized solution on surgical-site infection after open appendicectomy in perforated appendicitis (PLaSSo): randomized clinical trial

Correspondence to: Dr Saburi Oyewale (email: saburioyewale@yahoo.com)

Division of General Surgery

Department of Surgery

Afe Babalola University

Ado-Ekiti

Nigeria

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BJS Open, https://doi.org/10.1093/bjsopen/zrae121, published 16 October 2024

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I appreciate the authors' study1 comparing the effectiveness of a superoxide solution to normal saline in reducing surgical site infection (SSI) after open surgery for perforated appendicitis. The study protocol was well-designed and executed, however, there are some issues in the methodology.

The volume of the lavage used was based on body weight, but the authors did not consider the degree of peritoneal contamination to calculate the volume of lavage.

In patients with widespread peritoneal contamination, it might have been difficult to suction the peritoneal cavity completely of any remaining contaminant through the Lanz incision. There would likely have been a higher risk of organ space surgical-site infection in such patients.

There remains a need for a multicentre study in countries where open surgery remains the standard for acute appendicitis looking at volume of lavage and degree of contamination.