Sterile nacl or h2o???

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    hi. I was trained that we give sterile water for cancer cases (breast, etc...) Something about being hypotonic and its effect on lingering cells. I tried giving water at my new job and they thought I was crazy. Wouldn't take it...and started to question myself. LOL. So, is this some old school hairbrained idea that was beat into my head for years for no reason? What solution do you give?

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  3. 16 Comments...

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    Never heard of sterile water for cancer cases and the rationale is not, well rational. The sterile h2o when injected IV will hemolyze the rbc's in the immediate vicinity long before it would ever reach cancer cells, because it is a hypotonic solution. This is why sterile saline (isotonic) is always use as an IV flush.
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    Give it how? PO or IV?
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    neither...I am talking about during surgical procedures. What do you irrigate the wounds with?
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    We always use saline for irrigation. The only thing water is used for is cleaning instruments. Even our bacitracin irrigation is diluted in saline.
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    You're not crazy. We've also used sterile water to irrigate for cancer cases with the same reason about cancer cells. I think it might be an old school thing because the surgeons that request it seem to be nearing retirement I've also worked with a general surgeon who used it in big open bowel cases because he swears you can see bleeders more easily.
    Lasoniamacaroni likes this.
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    I have heard about using sterile water for irrigation in CA cases. I usually check with the surgeon. Most often we use saline to irrigate, but I give sterile water and saline to the field.
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    We have a few surgeons who use water for CA cases> One is just out of his residency, 2 is a breast CA specialists. Same rationale.
    I remember surgeons using a fresh clamp for every bleeder on a CA case-then using the same scissors for each cut. This was before staples were invented. Haven"t seen that technique in years-thank goodness, because you could use 50 plus clamps for one case. Of course, we didn't count instruments then, either!
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    Every surgical oncologist I have worked with use water for irrigation. Rational is that the free cells absorb and burst, killing the cell before possibly spreading.
    canesdukegirl likes this.
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    We, too, use sterile water in many cancer cases, surgeon dependent. The rationale is sound. It is believed that any free-floating cancer cells would lyse. No worries about RBC's; irrigation is not provided intravascularly. Most irrigation is sucked out as well prior to closure. As stated earlier, not all surgeons use water. We have a mixture of younger and older surgeons that use it. Dilution is the solution to pollution!

    Sent from my iPad (so excuse any typos and autocorrects!!) using

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