Question
Posted on: September 1 2018The composition of Decusorb paste please
Answer
Decusorb is the name used for a gel by the hospital pharmacy UGent. The composition, which they suggest is : R/Aqua reversed osmosis 57.69 G; Macrogol 400 5.31 G; Solutio Chlorhexidini digluconatis 20% 1.48 g; Carboxymethylamylum Natrijizz A (Primojel) 10.77 g
Primojel is a polymer similar to NaCMC but based on starch instead of cellulose. As a consequence, pharmacist Mieke Carlier asked whether there is no incompatibility between Chlorhexidinedine + and Carboxymethylamylum. This remark was not accepted by the hospital pharmacy. Consequently, Mieke examined her preparation in the Lab for Framaceutical microbiology, led by Prof. H. Nelis. In This lab, the germicidal activity was investigated on Escherichia coli ATCC 8739. The following pretalk were included in the study: (i) Chlorhexidine gel based on Carboxymethylamylum natritic (CHX-CMA); (ii) Chlorhexidine gel based on hydroxy-methyl-propyl-cellulose (CHX-HPMC); (iii) aqueous Solution of Chlorhexidine (CHX).
The results of bleeding were as follows
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- CHX 100 %
CHX-CMA 10.8 %
CHX-HPMC 100 %
HPMC gel only 8.7 %
It can therefore be decided that Primojel is incompatible with chlorhexidinedigluconate.
Two solutions offer themselves 1. Use of a HPMC 4000 gel instead of Primojel. But the specic characteristic of Primojel is that its strong water absorption capacity is lost or 2. Replacement of Chlorhexidinedigluconate by another antiseptic product. A specialist in wound care suggested to me, however, to opt for chloramine (Carrel Dakin, 0.5% chloramine) for a short period of treatment and then to work with a Hydrogel with Enzymes (Flaminal) . This will have to be consulted with the prescribing physician.
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