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  #1  
Old 05-21-2007, 01:12 PM
Arnold Winkelried Arnold Winkelried is offline
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(medical) - sterile water vs. saline solution vs. epsom salts - wound care

So I had a bad staphylococcus aureus infection in my leg. The doctor poked a hole (in the leg) to

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get the pus out and then put in a wick to keep the hole open. Now, a week later, he says that I don't need to use the wick anymore. Instead, use a "wet to dry" bandage: take some gauze, moisten it in sterile water, put a corner of the gauze in the hole in your leg, put a square of dry gauze on top, and tape. Change daily.

I trot off to the pharmacy just a few steps away - which is not a small pharmacy. Sterile water? Sorry, don't have any. How about some saline solution?

I go back to the doctor. The lady behind the desk (a nurse maybe? I'm not sure) says that saline water will be an acceptable substitute. I go back to the pharmacy, limping heavily so that people will feel sorry for me. They have a small bottle of saline water for irrigation, cost US$11. The pharmacist (she looks like a young high school student to me, but that's because I'm old) suggests dissolving epsom salts in water, it will work just as well and it's a lot cheaper. "A lot cheaper" being words that soothe my Swiss soul. I buy the epsom salts and just to be sure go back to the doctor's office. The lady behind the desk says that if the pharmacist says it's OK, then use epsom salts dissolved in water instead.

Medical question - is this the straight dope? Or do I need to go hunt down some sterile water? I could put a call in to the doctor to be sure but I hate to bother him for something trivial.
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  #2  
Old 05-21-2007, 01:18 PM
vetbridge vetbridge is offline
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I am not your doctor, and in any case you are not a dog. You could always boil the water first (thus practically achieving "sterile water"). The wound is open and draining as it is, I would have no problem with you using epsom salts/water unless the original problem were due to some horrible immune system problem.
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Old 05-21-2007, 01:18 PM
Canadjun Canadjun is offline
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How about boiling some tap water? Instant sterile water.
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Old 05-21-2007, 02:06 PM
Arnold Winkelried Arnold Winkelried is offline
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See, I wasn't 100% sure about that. So boiled tap water = sterile water? I wonder why the doctor or the pharmacist didn't mention it.
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Old 05-21-2007, 02:49 PM
vetbridge vetbridge is offline
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Well, "Sterile Water USP" lacks the mineral content that boiled tap water would have. In all honesty, in your situation I wouldn't even bother to boil the water.
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  #6  
Old 05-21-2007, 03:47 PM
Skammer Skammer is offline
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Is distilled water sterile? A gallon of distilled water at Wal-Mart is less than a buck.
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Old 05-21-2007, 04:16 PM
Jelymag Jelymag is offline
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If you have "city water," my thought would be that there is supposedly little to no bacteria there anyway. One of the things added (chloramine, I believe, in many places) is meant to kill bacteria and continue doing so while the water travels to its destination. When something goes wrong at the water treatment plant and bacteria finds its way in, they usually make public announcements to stop drinking the water. But I guess boiling it can't hurt, provided you don't boil it so much that you significantly increase the concentration of dissolved solids.

Is there a difference between this and what your doctor meant, I wonder; i.e. does sterile=no bacteria?

Distilled water is not sterile. It is just pure water, with nothing (or as close to nothing as practical) dissolved in it.

What about the sterile saline packaged for contact lens wearers? Same thing?
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Old 05-21-2007, 04:22 PM
Squink Squink is offline
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Quote:
Originally Posted by Skammer
Is distilled water sterile?
Only if the still is properly maintained, and the jars the water is collected in are sterilized.

"Sterile Water USP" is not only sterile, but depyrogenated.

Being cheap, I'd go with water +0.9% NaCl, boiled for 15 minutes in a clean glass container, and kept covered. However, it's not my leg.
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Old 05-21-2007, 05:40 PM
WarmNPrickly WarmNPrickly is offline
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Quote:
Being cheap, I'd go with water +0.9% NaCl, boiled for 15 minutes in a clean glass container, and kept covered. However, it's not my leg.
Not cheap enough. Epsom salts are cheaper. That is unless you have an industrial source I guess.

One time my parents told me to soak a wound in salt. I promptly emptied an entire bottle of sodium chloride into a gallon and made the world most expensive salt bath. They needed to be more specific when they said salt.
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Old 05-21-2007, 05:44 PM
Arnold Winkelried Arnold Winkelried is offline
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It's been said already, but to confirm, when the doctor told me to get sterile water I specifically asked about distilled water and he said no, not distilled water, sterile water.
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Old 05-21-2007, 05:47 PM
Arnold Winkelried Arnold Winkelried is offline
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P.S. Some more info - he said there was a bit of "dead tissue" on the sides of the hole. So I asked him if I could use maggots to get rid of it like they do in Britain (according to Scientific American). He said fine by him as long as I could find some "sterile maggots". I didn't ask at the pharmacy if they had any of those.
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  #12  
Old 05-21-2007, 05:52 PM
t-bonham@scc.net t-bonham@scc.net is offline
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Quote:
Originally Posted by Arnold Winkelried
They have a small bottle of saline water for irrigation, cost US$11.
Get a bottle of the saline solution sold for contact lens users -- it should cost much less than that.

And that's what we keep in our barn First-Aid kit for us in cleaning wounds. Our Veterinarian advised this -- said it was effective, cheap, and would last for a long time as long as it was unopened.
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Old 05-21-2007, 05:52 PM
Squink Squink is offline
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Quote:
Originally Posted by Arnold Winkelried
I specifically asked about distilled water and he said no, not distilled water, sterile water.
Yup, you never know what's been in the bottle before they filled it with distilled water.
Quote:
Originally Posted by Christopher
Epsom salts are cheaper.
Nope, cost is about $0.39 a pound for NaCl, vs $2.59 for 3 pounds of MgSO4. Besides, you only need 9 grams per liter.
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Old 05-21-2007, 05:56 PM
WarmNPrickly WarmNPrickly is offline
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Quote:
Nope, cost is about $0.39 a pound for NaCl, vs $2.59 for 3 pounds of MgSO4.
Then what the heck were my parents complaining about? I didn't use rock salt or anything I used iodized table salt. Also, my parents didn't say anything about concentration so I just dumped a lot in.
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Old 05-21-2007, 06:27 PM
vetbridge vetbridge is offline
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Quote:
Originally Posted by Arnold Winkelried
It's been said already, but to confirm, when the doctor told me to get sterile water I specifically asked about distilled water and he said no, not distilled water, sterile water.
It's an open wound. Unless you are seriously immunosuppressed, I assert that there is virtually no difference in this case between tap and sterile water. Is the interior of the wound sterile? I believe your MD is covering his arse. I would do the same in his circumstance.

(Apologies for my my stridence, posting trashed will do
that to ya.)

Last edited by vetbridge; 05-21-2007 at 06:28 PM..
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  #16  
Old 05-21-2007, 06:50 PM
Arnold Winkelried Arnold Winkelried is offline
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Thanks everybody. Since I'm paranoid about making a mistake, I guess my plan right now would be to buy some distilled water, boil it, throw some epsom salts in there (I've already bought that so why not use it), and use that concoction! Who knows, maybe I'll come up with some medical breakthrough.

vetbridge - no, I'm not seriously immunodepressed. Or if I were, I'm sure I would have noticed before now.

Last edited by Arnold Winkelried; 05-21-2007 at 06:51 PM..
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  #17  
Old 05-21-2007, 06:52 PM
Arnold Winkelried Arnold Winkelried is offline
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Quote:
Originally Posted by t-bonham@scc.net
Get a bottle of the saline solution sold for contact lens users -- it should cost much less than that.
I'll take a look at that next time I'm in the pharmacy. Are those usually "sterile"? What makes it special?

Last edited by Arnold Winkelried; 05-21-2007 at 06:53 PM..
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  #18  
Old 05-21-2007, 09:34 PM
drachillix drachillix is offline
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Quote:
Originally Posted by Arnold Winkelried
Medical question - is this the straight dope? Or do I need to go hunt down some sterile water? I could put a call in to the doctor to be sure but I hate to bother him for something trivial.
Per my wife/fellow doper Cyn

Part of the point of using sterile water is drawing crud out of the wound by osmosis, a normal saline solution would not have that effect.
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Old 05-21-2007, 10:55 PM
Nametag Nametag is offline
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Water will not draw anything out by osmosis -- it will, in fact, be drawn in, as water is the only thing that osmoses. Saline is better, as it will draw excess fluid out of the wound, and I've always preferred to rinse my own wounds with higher-than-normal saline or epsom salt.

As for answers above, most contact lens solutions are sterile preserved -- they used to use thimerosal, but various other preservatives have mostly replaced it. Preservatives can be irritating to already-damaged tissue.

I'm kinda guessing that a purulent boil, while not at tremendous risk for infection, is already putting the immune system through its paces. If it's available and not ruinously expensive, I'd stick with the sterile alternative.

Not a doctor, just a chemist with a biology degree.
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  #20  
Old 05-21-2007, 11:05 PM
1010011010 1010011010 is offline
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Sterile water is occassionally sold for humidifiers.
Don't know about it's suitability for serious medical use, but should be good enough for irrigation.
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