Acute Local Irritation Potential of a Novel Citrate-Based Irrigation Solution for Surgical Procedures: An In Situ Evaluation in a Rabbit Model

Background: Postoperative infections remain a major complication across a wide range of surgical procedures, largely due to bacterial biofilm formation. A novel citrate-based irrigation solution has shown promise in disrupting biofilms and reducing planktonic bacteria without cytotoxic effects. This study evaluates the acute local irritation potential of the solution on rabbit tissues in situ to assess its safety for intraoperative use. Methods: Fifty-eight adult rabbits underwent surgical exposure of articular-cartilage, cranial-dura-mater, mesentery, and pericardium tissues. Tissues were irrigated with either the novel citrate-based solution or a control solution (3% hypertonic saline) for 10–11 minutes. Histopathological evaluations were conducted at 30 minutes, 24 hours, and 7 days post-irrigation to assess tissue response, including inflammation, necrosis, neovascularization, and fibrosis. Results: The solution was classified as non-irritating compared to the control solution across all tissues and time points. When compared to naïve tissues, it was a non-irritant at 30 minutes and 24 hours post-irrigation and a slight irritant at 7 days for articular-cartilage, cranial-dura-mater, and mesentery. For the pericardium, it was a non-irritant at 30 minutes, a slight irritant at 24 hours, and a moderate irritant at 7 days. Conclusion: The novel citrate-based irrigation solution demonstrates minimal acute local irritation when applied to rabbit tissues in situ, with slight to moderate irritation observed in certain tissues at specific time points. These findings support its potential as an intraoperative irrigation solution with minimal risk for irritation, but further studies are necessary to fully assess its safety and long-term effects in clinical applications.