Alfredo E. Hoyos，MD^D；Mauricio E. Perez Pachon，MD^D;
Matt Stefanelli，MD；Mariana Borras Osorio, MD； Justo Calderon
Mendoza，MSc；Maria Paula Castiblanco，MD；
Mateo Leon Machicado，MD；and Andres Pinzon Valero，MD

Abstract
Background: Despite the general safety of liposuction and fat grafting procedures，surgical-site infections (SSIs) remain a significant concern. These infections, ranging from minor to severe，can arise from various sources and pose a substantial burden. The overuse of antibiotics has led to increased antimicrobial resistance，highlighting the need for alternative infection prevention strategies like stabilized hypochlorous acid (s-HOCl). Objectives: The aim of the authors of this study is to evaluate the efficacy and safety of s-HOCl in preventing SSIs following liposculpture and other body contouring procedures. Methods: A prospective cohort study and matched control cohort were conducted at a single plastic surgery center in Bogota，Colombia (Dhara Clinic). Adult patients scheduled for liposculpture and fat grafting from January 2020 to December 2023 formed the intervention group，receiving s-HOCl as a washing solution for adipose grafts. A matched control cohort was drawn from patients who underwent similar procedures from January 2017 to December 2019 without s-HOCl. Data on demographics，surgical characteristics，and SSI outcomes were collected and analyzed. Results: A total of 1008 patients were included，with 502 in the s-HOCl group and 506 in the control group. The infection rate in the s-HOCl group was 0.2 per 100 grafted muscles, compared with 0.54 in the control group. Relative risk of SSIs in the s-HOCl group was 0.4，indicating a reduction in infection rates. The small absolute risk reduction of 0.59% underscores the clinical importance，considering SSIs, although rare，are severe and life-threatening events，with significant impact on outcomes and healthcare costs. A reduction in the severity of infection and the level of required treatment was also observed. Conclusions: s-HOCl demonstrated potential to reduce SSI risk following liposuction and fat grafting. This intervention offers a valuable alternative to antibiotics，effectively reducing infection rates and contributing to improved patient outcomes and public health in postantibiotic era.