Posted By Lesley Palmer Hello all I really need some help here! A surgeon needs near boiling sterile water to put into a tall sterile flask, then kept within a sterile field for the duration of surgical operation. In the flask he will put a sterile telescope which will enter the patients abdominal cavity. Why? Because he needs to pump gas into patients abdominal cavity, the gas is cold (for obvious reasons it can't be heated)when he puts the telescope into abdominal cavity and pumps in gas the telescope mists and then he can't see. By heating the telescope to above the temperature of the patients internal temp. the telescope remains clear. The operation he will perform means that even extremely difficult to treat patients will get their operation and a successful recovery, its ground breaking stuff, and therefore the "RISK" of them not having the op. must be ballanced against the Risk involved in providing the op. Could be you, me or someone we love. At present they provide the sterile hot water this way: A sealed litre bottle of sterile water (as supplied by maunfacturer)is put into a domestic microwave for 5 minutes which is in the theatre suite kitchen and then transported the very short distance to the operating theatre. The person carrying the bottle has PPE and the bottle is still sealed, sterility is not compromised. But I was carrying out the annual Fire Risk Assessment for theatres with the fire officer and whilst in the kitchen a sterile bottle of water was in the microwave, the plastic was greatly expanding, it was very obviously a health and safety NO No.When the fire officer had gone I checked the sterile bottle it said "not to be heated above 65.c" no mention of 'microwavable safe'. I phoned the manufacturer and they said under no circumstances can the bottle be microwaved.So here I am, the patient needs the operation ( it might be life saving) but the current practice is unsafe because it is against manufacturers recommendations. I need to be able to recommend a method. any ideas??? this is serious so nothing too frivolous please, I just know all you clever people will have an answer, many thanks Lesley.

Posted By Merv Newman It seems that the water needs to be maintained above 37°C for a considerable period while respecting sterility. Can your suppliers deliver water in glass bottles ? They always used to. Alternatively do you have the facilities to autoclave a bottle of water ? (but I would have thought that Normal saline would have been more appropriate) If so then you can decant from plastic to glass and then sterilise. The only other possibility that immediately comes to mind is a heated water bath at about 60 to 70. Or, as we are only talking about 37+, and not necessarily "near boiling", water from the hot tap comes at about 50-60°C. With all the chlorine that Thames Water put in (4ppm residual Cl ?) it should be reasonably sterile. Would that meet your standards ? Merv

Posted By Jay Joshi Sorry, did not read that you microwave a closed sterile solution in plastic bottle. Most plastic containers are not meant to be designed/tested for pressure that you have described--unless the supplier tests it, heating any "closed" container in a microwave is a no no!

Posted By Lesley Palmer Thanks to all, I have gone to Medical equipment manufacturers to see what they can invent, and at what cost!! Lesley