Selection of irrigation fluid to eradicate free cancer cells during head and neck cancer surgery.

Abstract

BACKGROUND: Free cancer cells can be spilled out from exposed tumors or ruptured tumors. We examined the cytocidal effect of various irrigation fluids on free cancer cells in an animal wound model mimicking head and neck surgery. METHODS: Cancer cell-contaminated wounds were made with C3H/HeJ mice and syngeneic squamous cell carcinoma (SCC VII) cells. Distilled water, 5% povidone-iodine, 1.5% H(2)O(2), normal saline, and cisplatin were used to irrigate for 5 minutes. In vitro tumor growth assays were done with different concentrations and exposure times of povidone-iodine and distilled water. RESULTS: In the animal study, povidone-iodine significantly inhibited tumor growth. Povidone-iodine caused substantial inhibition of in vitro tumor growth, even at the concentration of 0.05%. After 30 seconds of exposure to 1% povidone-iodine, cancer cells were completely inhibited. CONCLUSIONS: Povidone-iodine could be selected preferentially for the irrigation fluid during head and neck surgery, especially when the wound is suspected of cancer cell contamination.