Comparative Study of Result of Peritoneal Wash with Normal Saline Vs Saline and Metronidazole in Patients Undergoing Exploratory Laparotomy for Perforation Peritonitis

Introduction

Perforation peritonitis is a significant surgical emergency with high postoperative infectious morbidity. During exploratory laparotomy, lavage with normal saline is routine, and the addition of metronidazole may be useful for providing additional antimicrobial activity against anaerobic organisms. This study compared postoperative outcomes following saline lavage with or without metronidazole. Materials and Methods: This randomized clinical trial was carried out in the Department of General Surgery, Sanjay Gandhi Memorial Hospital, Delhi between March 2024 and August 2025. 54 patients, 18-60 years of age, with perforation peritonitis undergoing exploratory laparotomy were randomly divided into two equal groups. Group 1 (n=27) was given 2L of normal saline with 100ml of metronidazole and Group 2 (n=27) was given 2L of normal saline alone. Surgical site infection (SSI), sepsis, intra-abdominal abscess, wound dehiscence, burst abdomen and hospital stay were evaluated. Categorical variables were analyzed using Chi-square test and p value <0.05 was taken as statistically significant.