Can bacteriostatic H2o be used to reconstitute STS for sclerotherapy?

Question

I use bacteriostatic 0.9% NaCl but thought I read somewhere that bacteriostatic water can also be used?

Nelson Lee Novick, MD · Answer

Depending upon the particular injectable substance used for sclerotherapy, bacteriostatic water, bacteriostatic saline, or the latter combined with dilute local anesthetic, with or without epinephrine, may be used for the the treatment of tiny starburst leg veins. I find that using the latter, especially with a tiny amount of epinephrine (adrenaline), makes the treatment more comfortable for the patient and the overall effect somewhat better in my estimation since the blood vessel constricting effects of the epinephrine promote longer and better contact of the sclerosant with the inner blood vessel walls.

John Landi, MD · Answer

I always use bacteriostatic .9% saline to mix the sclerotherapy solutions.  I have never used bacteriostatic water but it can be used.

Hratch Karamanoukian, MD, FACS · Answer

I use physiologic saline 09% to prepare my sclerosant solutions. Epinephrine is something that I don't use or add because it can potentially cause tissue necrosis if it infiltrates into tissue (theoretical concern). Sterile water is also something that I don't recommend for injection into vessels or skin. Stick with the published literature and emperical observations made from thousands of providers who use physiologic solutions to perform thousands of sclerotherapy procedures every day. Having said that, if you learn the technique from someone who has expertise and success with the use of mixing solutions with epinephrine, etc., do it.

Can bacteriostatic H2o be used to reconstitute STS for sclerotherapy?

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