Saline is a solution of sodium chloride in water, and it can be used for multiple purposes including intravenous infusions, nasal irrigation, eye drops, and wound cleaning. Several formulations of saline are available with added ingredients including Lactated Ringer's solution and Acetated Ringer's solution.
Hashemi, A., Bahrololoumi, Z., Khaksar, Y., Saffarzadeh, N., Neamatzade, H., & Foroughi, E. (2015). Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: A systematic review. Iranian Journal of Pediatric Hematology and Oncology, 5, 106–112.
PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Pediatrics and palliative care
None of the mouth rinses were definitely effective in preventing chemotherapy-induced oral mucositis in children. Normal saline had a preventive effect in patients receiving chemotherapy, radiotherapy, and hematopoietic stem cell transplantation, but other studies have shown less efficacy than chlorhexidine or honey with saline. Benzydamine was less effective than chlorhexidine.
There was limited evidence for agents to prevent or manage oral mucositis in children.
Mouth rinses are an important component to oral care in the prevention of mucositis in pediatric patients receiving chemotherapy. Nurses need to continue research to develop evidence-based practice guidelines for this debilitating side effect of chemotherapy.
McGuire, D.B., Fulton, J.S., Park, J., Brown, C.G., Correa, M.E.P., Eilers, J., . . . Lalla, R.V. (2013). Systematic review of basic oral care for the management of oral mucositis in cancer patients. Supportive Care in Cancer, 21, 3165–3177.
STUDY PURPOSE: To systematically review oral care interventions for the prevention and treatment of oral mucositis (OM) in patients undergoing cancer treatment
TYPE OF STUDY: Systematic review
DATABASES USED: Ovid MEDLINE
KEYWORDS: mucositis, stomatitis, cancer, oral care, oral care protocol, dental care, dental cleaning, oral decontamination, oral hygiene, saline, sodium bicarbonate, baking soda, chlorhexidine, magic/miracle mouthwash, calcium phosphate
INCLUSION CRITERIA: Primary research article, reflects a variety of research designs, rested the effects of intervention on severity of OM or mucositis-related symptoms
EXCLUSION CRITERIA: Review articles, clinical case reports, literature reviews, non-research articles
TOTAL REFERENCES RETRIEVED = 129
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Hadorn et al. criteria was used to assess the flaws in the selected publications, and levels of evidence were rated using the Somerfield schema.
FINAL NUMBER STUDIES INCLUDED = 52
SAMPLE RANGE ACROSS STUDIES, TOTAL PATIENTS INCLUDED IN REVIEW: Not stated
PHASE OF CARE: Active antitumor treatment
The guidelines are as follows.
Oral care protocols are recommended to patients for the prevention and treatment of OM. Chlorhexidine is not recommended for patients with head and neck cancer who receive radiotherapy treatment.
Evidence for interventions to prevent and treat OM are limited, making guideline recommendations difficult.
Nurses should teach patients appropriate oral care to help prevent OM.
Blanchard, D., Bollet, M., Dreyer, C., Binczak, M., Calmels, P., Couturaud, C., ... & Albert, S. (2014). Management of somatic pain induced by head and neck cancer treatment: Pain following radiation therapy and chemotherapy. Guidelines of the French Otorhinolaryngology Head and Neck Surgery Society (SFORL). European Annals of Otorhinolaryngology, Head and Neck Diseases, 131, 253–256.
PHASE OF CARE: Active antitumor treatment
Many systematic reviews were used as references such as the Cochrane Library, but no number articles reviewed or how these were chosen were mentioned. Selection was based on each reviewer’s experience.
The categorization using the ANAES guides to determine level of evidence and grades was appropriate. However, the search methods used in these guidelines were not clearly stated and need reconfirmation because there was no way to know whether the search was comprehensive. The recommendations were grade B and expert opinions.