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0.045% DAC N-055 a choice for poor Afghan surgical patients?
BMC Proceedings volume 5, Article number: P246 (2011)
Introduction / objectives
O2 enriched pharmaceutical chlorite [NaClO2 German Drug Codex monograph DAC N-055, 1990] contains Na2Cl2O6 formerly called TCDO, (NaClO2)4·O2 fights tissue infections and promotes wound granulation of radiogenic ulcers [http://www-pub.iaea.org/mtcd/publications/pdf/te_1300_web.pdf]. Under our hygienic conditions the intra- and postoperative topical use of 0.045% DAC N-055 helps us to deal with bone & tissue infections in orthopaedic surgery in Mazar. Here we document 4 cases out of the total number of 26 patients, we monitored in the former Military Hospital in Mazar 2004 - 2006 to familiarize ourselves with this German drug first registered as Oxoferin® in 1983.
The speed of ·ClO2 release from 0.045 % DAC N-055 (max. 160 ppm) increases with decreasing pH. ·ClO2 induces no resistance. In all patients the field of surgical intervention is rinsed several times with 0.045 % DAC N-055 in saline especially during the operation, especially before wound closure and dressed with cotton gauzes kept moist till the patient is discharged home. Post-OP irrigations are practised with 0.045 % DAC N-055 for septic arthritis (closed method) and osteomylitis (open method).
1/2 septic arthritis, osteomyelitis cases and 2/22 osteomyelitis cases are photo-documented. Without antibiotics, septic arthritis had an excellent functional outcome after 6 weeks, the open fracture with skin defect received mesh graft on excellent granulation after 1 month and was completely closed after 3 months. 11/22 osteomyelitis cases could be monitored for 6 to 18 months, 6 cases relapsed within this time, for 8/11 patients antibiotics were not available.
If 4.5% DAC N-055 could be sold in Afghanistan at 50% of the price of the finished drug Oxoferin® sold in Pakistan this could help poor patients in traumatology.
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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Stahl, K., Darmangar, H. 0.045% DAC N-055 a choice for poor Afghan surgical patients?. BMC Proc 5 (Suppl 6), P246 (2011). https://doi.org/10.1186/1753-6561-5-S6-P246
- Tissue Infection
- Wound Closure
- Open Method
- Open Fracture