AQUIS Medical Products APPLICATION MANUAL Part Acute and Chronic Wounds Anosteralyth-Solution Neutrosteralyth-Solution Anosteralyth-Gel Neutrosteralyth-Gel Wound Irrigation Solution Irrigation Solution Gels
Introduction Dear users, with this application manual we would like to give you some practical tips for the use of Steralyth -Solutions and Steralyth -Gels in wound treatment. The Steralyth-Products Anosteralyth and Neutrosteralyth are characterized by very good wound cleansing and decontaminating effects. Furthermore they posses unique electro-chemical properties, which can stimulate and optimize the physiological wound healing processes. Apart from numerous wound-type related sample applications you can find a summary of important notes in the annex. We are wishing you success for the application and would be glad about your feedback. Your Aquis-Team
Contents Introduction Ulcer... 4 Decubitus (pressure ulcer)... 5 Burns... 6 Intertrigo ( soreness ) / Diaper Dermatitis... 7 Paronychia... 8 Annex: Important Information... 9 References... 10 List of Products Application manual, Version 2.3, Feb. 2010 - AQUIS GmbH
Ulcer Ulcer with substantial erosion of the skin or mucous membrane (in depth) due to a topical cause or general disease. The wound site of the ulcer probably is smeary coated, gangrenous, crater-shaped or elevated and covered with granulations. Ulcus cruris Products On the skin: Anosteralyth-Solution 30% / Anosteralyth-Gel On mucous membranes: Neutrosteralyth-Solution 30% / Neutrosteralyth-Gel Wound dressings / dressing materials Gauze compress (proportionate to ulcer size); Absorbent compress. Covering with waterproof, self-adhesive dressing film; on irritated ambient skin or very widespread wounds covering with dressing film. (See annex - important information / dressing film.) Standard therapy Cleansing: irrigation of the wound with solution 30%; mechanical wound cleansing with moistened compresses / gauze balls if required. Moisture: for superficial ulcer: moisten wound-sized compress well with Steralyth-Solution 30%, apply on the wound and cover with waterproof dressing film; for deep ulcer: additionally apply Anosteralyth-Gel on the moistened compress, proportionally to the wound size; for high exudate level: apply an appropriately absorbent dressing; application of gel is also favourable (apply slightly; see annex - maceration); for mucous membranes: apply Neutrosteralyth-Gel or insert moist compress (depending on localization). Frequency of application Moist dressings: daily application. With severe contamination in the early stage application twice a day is favourable. Application on mucous membranes: moist compress or application of gel, 1-2 x daily (more often if required) Information More intensive moisture by additional application of gel (also for superficial ulcer). Dependig on the primary disease mind pressure relief / compression therapy / elevated position of the legs. 4
Decubitus (pressure ulcer) Formation of ulcer and necrosis, mostly infected, on the skin or mucous membrane due to chronic topical pressure and resulting topical ischemia (e.g. bedsore from bedriddenness or as a result of bad-fitting prosthesis etc.). Decubitus, coccyx, stage 3-4 Products Anosteralyth-Solution 30% / Anosteralyth-Gel Wound dressings / dressing materials Gauze compress (proportionate to the decubitus size); Absorbent compress. Covering with waterproof, self-adhesive dressing film; on irritated ambient skin or very widespread wounds covering with dressing film. (See annex - important information / dressing film.) Standard therapy Cleansing: irrigation of the wound with solution 30%; mechanical wound cleansing with moistened compresses / gauze balls if required. Moisture: for superficial decubitus moisten wound-sized compress well with Steralyth-Solution 30%, apply on the wound and cover with waterproof dressing film; for deep decubitus additionally apply Anosteralyth-Gel on the moistened compress, proportionally to the wound size. For high exudate level: apply an appropriately absorbent dressing; application of gel is also favourable (apply slightly; see annex - maceration) Frequency of application Daily application. With severe contamination in the early stage application twice a day is favourable. Information More intensive moisture by additional application of gel (also for superficial decubitus). Even under Steralyth-Therapy attention should be paid to pressure relief. 5
Burns Ulcer with substantial erosion of the skin or mucous membrane (in depth) due to a topical cause or general disease. The wound site of the ulcer probably is smeary coated, gangrenous, crater-shaped or elevated and covered with granulations. Products Anosteralyth-Solution 30% / Anosteralyth-Gel; Neutrosteralyth-Solution 30% / Neutrosteralyth-Gel. Wound dressings / dressing materials Gauze compress (proportionate to wound size); Covering with waterproof, self-adhesive dressing film; on irritated ambient skin or very widespread wounds covering with dressing film. (See annex - important information / dressing film.) Active agent free spacer grids. Standard therapy A) Burns first degree to beginning second degree (blistering): wet packs with Steralyth-Solution 30%, intermittent application of gel. B) Burns with open wounds formation: Cleansing: irrigation of the wound with solution 30%; cautious mechanical wound cleansing with moistened compresses / gauze balls if required. Moisture: moisten wound-sized compress well with Steralyth-Solution 30%, apply on the wound and moisten regularly; where applicable cover with waterproof dressing film. Intensified by additionally applying gel to the moistened compress. For burns in mucosal areas: insert compresses moistened with Neutrosteralyth-Solution, supplementary Neutrosteralyth-Gel can be applied. Frequency of application Wet packs: 2-3 x daily (more often if required). Moist dressings: at least 1 x daily. Application on mucous membranes: moist compress, 1-2 x daily (more often if required) Information Dressings can be combined with spacer grids (active agent free) as needed.. 6
Intertrigo ( soreness ) / Diaper Dermatitis Bright red, weeping erythema (without crust or scales) on contact pints of the skin, primarily in armpits and inguinal areas, on perineum, gluteal fold, umbilicus, beneath the breasts, between fingers and toes; either due to maceration with posterior bacterial or mycotic infection or as eczematizing seborrhoic eczema. Products Anosteralyth-Solution 30% / Anosteralyth-Gel; with additional fungal infection Neutrosteralyth-Solution 30% or Neutrosteralyth-Gel. Wound dressings / dressing materials Gauze compresses. Standard therapy Cleansing: soft mechanical cleansing with Steralyth-moistened compresses / gauze balls. Wound dressing: moistened compresses (with Steralyth-Solution 30%) or application of gel on the wound areas and insertion of a compress into the body fold (possibly moistened with Steralyth-Solution 30%). Frequency of application 1-2 x daily, more often if required (e.g. with every change of diapers). Information Prophylactic application 1-2 x per week, besides appropriate skin care. 7
Paronychia Inflammation of the wall of nails; acute (Staphylococcus or Streptococcus, viruses or fungi) or chronic (primarily candida). In many cases due to disposition factors like routes of entry (injuries, ingrown nails), maceration/deformation or immunodeficiency (e.g. Diabetes mellitus). Products Anosteralyth-Solution 30% / Anosteralyth-Gel. Wound dressings / dressing materials / Material Gauze compresses; tube bandages; adhesive plaster with uncoated wound dressing. small jar. Standard therapy Baths (e.g. in a small glass or plastic bag). As intensifying or sole procedure, if baths are impossible, apply gel on a plaster or use a moist dressing with gauze compress and tube bandage. Frequency of application Bath: 2-3 x daily, approximately 15 minutes. Moist dressing / plaster: 1-2 x daily Information The standard therapy can also be applied after surgical intervention. Also useful as preventive procedure (e.g. after cutting the perionyx). 8
Annex - Important Information Warning: Anosteralyth-Solution as concentrate or ready for use, 30% solution has a strong resp. medium chlorine smell. Both for dilution of the concentrate as well as in application direct inhalation has to be avoided. Particular caution with asthma disease or chlorine allergy. Hence for asthmatics and allergic persons the use of Neutrosteralyth-Solution is recommended. Diluation: Due to the decontamination properties of Anosteralyth-Solution and Neutrosteralyth-Solution normal drinking water can be used for dilution, but of course Aqua destillata or water for injection as well. Concentration: Anosteralyth-Solution and Neutrosteralyth-Solution can be supplied both as concentrate and ready for use solution. The concentrate has to be diluted to a maximum concentation of 30%, which also is the most common form of application. Preparation of a 30% solution - example for 1 liter ready for use solution: Mix 700 ml drinking water and 300 ml concentrate in a measuring cup of plastic or glass. For specific applications - like for prevention - a lower concentration can be applied. Irrigation: For the irrigation of wounds or skin areas with Anosteralyth-Solution or Neutrosteralyth-Solution syringes or spray bottles are particularly suitable. Bathing: Very intensive way of treatment; e.g. for onychia using a small glass; lower consumption of Steralyth-Solutions by bathing using plastic bags. Dressing film: There is a wide variety of self-adhesive and non-adhesive waterproof medical dressing films on the market. 9
Maceration: From our experience we can say, that intact as well as irritated ambient skin is not damaged by moisture with Steralyth-solutions. To the contrary: it is even useful to treat the irritated ambient skin for a few days as well. Softened horny layers are easy to remove mechanically. For wounds with high exudate level protection of the wound edge is important (e.g. with Cavilon ). Suitable for skin care are for example Optiderm F Creme or Bepanthen wound and healing ointment. Zinc-containing ointments are unsuitable. Adhesion due to drying up of dressings: Moisten thoroughly, wait for a few minutes, and then remove the dressing. Interactions: The application in combination with other disinfection or irrigation solutions carries the risk to impair the efficiency. When applying dressings containing agents / alginate or silver coated dressings Steralyth-Solutions should only used for irrigation. Selection criteria Anosteralyth Neutrosteralyth Start of therapy Start of therapy for sensitive / allergy-prone persons / very sensitive ambient skin Chronic wounds Infected wounds Stronger effect, but stronger chlorine smell Mucous membranes Fungal infections (e.g. Intertrigo) Minor chlorine smell, gentle in application In general Anosteralyth-products can be substituted by Neutrosteralyth-products, except when solely Neutrosteralyth is recommended (e.g. application on mucous membranes). References: Description of the indications: Roche Lexikon Medizin und Gesundheit; www.gesundheit.de/roche 10
List of Products Steralyth products Product PZN Anosteralyth (concentrate) 250 ml 6400338 Anosteralyth (concentrate) 500 ml 7281829 Anosteralyth (concentrate) 1 Liter 7285402 Anosteralyth (concentrate) 3 Liter 7285419 Anosteralyth-solution 30% 250 ml 6400396 Anosteralyth-solution 30% 500 ml 5375489 Anosteralyth-solution 30% 1 Liter 5375472 Anosteralyth-Gel 30 ml 7285655 Anosteralyth-Gel 100ml 7285678 Neutrosteralyth (concentrate) 250 ml 6400344 Neutrosteralyth (concentrate) 500 ml 7285709 Neutrosteralyth (concentrate) 1 Liter 7285810 Neutrosteralyth (concentrate) 3 Liter 7285980 Neutrosteralyth-solution 30% 250 ml 6400373 Neutrosteralyth-solution 30% 500 ml 5375466 Neutrosteralyth-solution 30% 1 Liter 5375443 Neutrosteralyth-Gel 30 ml 7286100 Neutrosteralyth-Gel 100 ml 7286123
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