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A microbiologic study of diluted sclerotherapy solutions
1Division of Dermatology, Cornell University Medical College, New York, New York.
Background:
As sclerotherapy has become more of an exact science it has become appropriate to dilute various sclerosing solutions to produce the least concentration of sclerosant producing effective endosclerosis of a given vessel diameter--the minimal sclerosant concentration.
Objective:
In this setting it has become necessary to take into account various microbiologic considerations. Contamination of infusates is the most common cause of epidemic device-related bloodstream infections. With these considerations in mind, the following study was undertaken to determine the bacterial and fungal content of varied concentrations of four commonly employed sclerotherapy agents.
Methods:
Dilutions were made of hypertonic saline 23.4% to 11.7% with both bacteriostatic water and 0.9% normal saline, Polidocanol 0.5% to 0.25% with bacteriostatic water, sodium tetradecyl sulfate 1.0% to 0.5% with bacteriostatic water, and polyiodide iodide 2% to 1% with bacteriostatic water under sterile conditions. Each sclerosant was analyzed for bacterial, fungal, and spore content at determined time intervals with standardized utilization indices for up to 3 months.
Results:
At each sclerosant concentration for sodium chloride, polidocanol, sodium tetradechol sulfate, and polyiodide iodide at each study design time interval for sampling all bacterial and fungal cultures remained sterile.
Conclusions:
With appropriate aseptic techniques we may dilute sclerosing solutions to desired concentrations that will remain sterile for a period of at least 3 months under daily usage conditions.