Flexible ureteroscopic lithotripsy (FURS) is a minimally invasive procedure for the treatment of upper urinary tract stones, but postoperative infection is still one of the common complications. As a highly effective and safe antibacterial agent, hypochlorous acid (HOCl) has shown potential application value in urological surgical irrigation fluids in recent years. This article reviews the antibacterial mechanism and biosafety of hypochlorous acid flushing solution and its role in preventing infection after FURS surgery, and explores its clinical application prospects.
Infection after ureteroscopic lithotripsy (such as urinary tract infection, fever, and even urosepsis) is an important factor affecting the patient's prognosis. Traditional intraoperative irrigation fluids (such as normal saline) lack antibacterial effects, and antibiotic irrigation may increase the risk of drug resistance. Hypochlorous acid is a strong oxidant naturally secreted by neutrophils. It has broad-spectrum antibacterial (including bacteria, fungi and viruses), rapid bactericidal and wound healing properties, and has no significant toxicity to tissues, making it a potential ideal surgical irrigation fluid.
Antibacterial mechanism and safety of hypochlorous acid
Antibacterial effect :
- Hypochlorous acid destroys the cell membranes, proteins and DNA of microorganisms through oxidation, and is highly effective in killing common urinary tract pathogens such as Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa.
- Studies have shown that 0.01% hypochlorous acid solution can inactivate 99.9% of bacteria within 30 seconds, which is better than saline.
Biocompatibility :
- Hypochlorous acid is non-toxic to human cells at low concentrations (<0.05%) and does not damage the integrity of the urothelium.
- Compared with antibiotics, hypochlorous acid is less likely to induce drug resistance and is suitable for long-term or repeated use.
The bactericidal effect of hypochlorous acid (HOCl) is mainly achieved through the following mechanisms:
Oxidative damage to microbial structure : HOCl can penetrate bacterial cell membranes and oxidatively damage proteins, lipids and DNA.
Decomposition of biofilm : It has a strong clearing effect on biofilms formed by drug-resistant bacteria (such as MRSA and Pseudomonas aeruginosa).
High safety : HOCl rapidly decomposes into water and chloride in the neutral environment of the human body, with no residual toxicity and no damage to normal tissues.
Compared with antibiotics, HOCl is less likely to induce drug resistance and has a broader antibacterial spectrum, making it suitable for use as an intraoperative flushing fluid.
Application of hypochlorous acid flushing solution in fURS
Clinical research evidence
Several studies have shown that hypochlorous acid irrigation can significantly reduce the risk of infection after fURS surgery:
Reducing bacterial load : Flushing with low concentration (0.005%-0.01%) HOCl during surgery can effectively reduce the number of urinary tract bacteria.
Reduce the postoperative fever rate : A randomized controlled trial showed that the incidence of postoperative fever in the HOCl irrigation group was reduced by more than 50% compared with the saline group.
Biofilm elimination : HOCl can prevent biofilm-related infections in patients with long-term indwelling ureteral stents.
How to use
Intraoperative flushing : HOCl solution (concentration ≤ 0.01%) was continuously perfused during the lithotripsy process to keep the surgical field clean.
Postoperative instillation : HOCl solution is injected through the ureteral catheter to reduce residual bacterial colonization.
Technical advantages of Chlory's hypochlorous acid generator
Chlory's hypochlorous acid generator uses brine electrolysis technology to generate high-purity, additive-free HOCl solution in real time. Its core advantages include:
Ready-to-use : Avoid the activity attenuation problem of traditional hypochlorous acid solution during storage and ensure the bactericidal effect.
Adjustable concentration : The HOCl concentration (0.001%-0.1%) can be adjusted according to surgical needs, taking into account both safety and effectiveness.
Cost-effectiveness : Compared with pre-packaged disinfectants, on-site preparation can reduce the cost of medical consumables.
Environmental protection : No harmful by-products, in line with the trend of green medicine.
Conclusion and Outlook
Hypochlorous acid irrigation solution has shown significant infection prevention potential during fURS, especially for high-risk patients (such as those with diabetes or a history of urinary tract infection). Chlory's hypochlorous acid generator provides an efficient and convenient HOCl solution for clinical use, and its long-term benefits can be further verified through multi-center studies in the future. Combined with precise antibiotic management, HOCl technology is expected to become a new standard for infection prevention and control in urology.
For more information about Chlory and hypochlorous acid generators, visit www.Chlory.com or contact info@chlory.com
