Sterile nacl or h2o???

  1. 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?
    •  
  2. 16 Comments

  3. by   Pets to People
    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.
  4. by   Double-Helix
    Give it how? PO or IV?
  5. by   Lasoniamacaroni
    neither...I am talking about during surgical procedures. What do you irrigate the wounds with?
  6. by   Rose_Queen
    We always use saline for irrigation. The only thing water is used for is cleaning instruments. Even our bacitracin irrigation is diluted in saline.
  7. by   Sezza83
    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.
  8. by   2001ORRN
    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.
  9. by   mbrj
    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!
  10. by   Argo
    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.
  11. by   CIRQL8
    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 allnurses.com
  12. by   ChristineAdrianaRN
    Very interesting conversation! I have never heard this. I don't see a whole lot of cancer because I work in pediatrics, but even with malignant brain tumor cases, I have only seen saline. But our neurosurgeon is young, so maybe it is old school? But the rationale sounds legit.
  13. by   CIRQL8
    Quote from ChristineAdrianaRN
    Very interesting conversation! I have never heard this. I don't see a whole lot of cancer because I work in pediatrics, but even with malignant brain tumor cases, I have only seen saline. But our neurosurgeon is young, so maybe it is old school? But the rationale sounds legit.
    Well, in neurosurgery, I've never seen water, either. I didn't really separate specialties. I was only referring to abdominal cases. (GYN, general, some URO).

    Sent from my iPad (so excuse any typos and autocorrects!!) using allnurses.com
  14. by   goats'r'us
    i've heard this one too, and there are a few surgeons who go with it, but most use saline.

    i got similar crazy looks when i started at a new hospital and found that they use saline in neurosurgery. i was taught at my previous hospital that ringers solution is the closest thing to CSF so should always be used in neuro, but my new hospital didn't even stock it!

close