Non Medicated Tulle Dressing

DESCRIPTION
Atrauman is a ready to use Tulle, impregnated with hydrophobic neutral ointment base (Yellow soft paraffin)

FEATURES & BENEFITS
• Paraffin maintains a moist environment & prevents adherence to surface
• Allows easy drainage of wound exudates
• Changing of dressing is painless due to non-adhesion to wound
• Has high absorbency that keeps even heavy exuding wounds clean
• It is terminally sterilized by gamma irradiation

INDICATIONS
• Minor burns & scalds
• Lacerations, Abrasions and other skin loss wounds
• Donor and Recipient graft sites
• Leg ulcers


CONTRA INDICATIONS
Although there are no absolute contra-indications to the use of Atrauman, if the dressing is placed upon a heavily exuding wound, its semi-occlusive nature may cause tissue maceration by preventing the free movement of exudate away from the surface of the wound. This is less likely to occur if a dressing bearing the lower loading of paraffin base is used.


APPLICATION PROCEDURE
Atrauman is applied directly to the surface of the wound and covered with an absorbent pad held in place with tape or a bandage, as appropriate. Frequency of Change: The frequency of dressing changes will depend entirely upon the nature of the wound. If Atrauman is left in position for prolonged periods of time, it can become adherent and cause tissue damage upon removal.

PRESENTATION
Atrauman 10 cm x 10 cm (20 dressings in an Aluminium container) Atrauman 10 cm x 10 cm (2 dressings in a pouch pack)

Chlorhexidine Medicated Tulle Dressing

DESCRIPTION
Atrauman C is a ready to use Tulle, impregnated with Chlorhexidine

FEATURES & BENEFITS
• Chlorhexidine is active against a wide range of bacteria thus controls bacterial overgrowth.
• No cross-resistance has been demonstrated
• Change of dressing is painless due to the non-adherent property
• Terminally sterilized by gamma irradiation

INDICATIONS
• Recommended for prophylaxis on vulnerable wounds to reduce the risk of infection ? In already infected wounds can be used in conjunction with other topical & systemic antibacterial agents
• Postoperative dressings particularly after plastic surgery, skin transplants

CONTRAINDICATIONS
Atrauman C should not be used on more than 10% of the body area. Dermatitis, contact sensitivity or photosensitivity may rarely occur. Anaphylactic reaction to Chlorhexidine has been reported, but is rare. Avoid contact with eyes, the middle ear, meninges and brain. Atrauman C is incompatible with soaps, other anionic materials, as well as potassium iodide. The use of Atrauman C with oxidizing wound cleaning agents should be avoided.

APPLICATION PROCEDURE
Atrauman C is applied directly to the surface of the wound and covered with an absorbent pad held in place with tape or a bandage, as appropriate Frequency of Change: Atrauman C may be left in place when the absorbent secondary dressing is changed. The frequency of changing will depend on the clinical circumstances and this can vary from more than once per day to twice per week. If the dressing adheres, soak it gently with sterile saline solution.

PRESENTATION
Atrauman C 10 cm x 10 cm (20 dressings in an Aluminium container) Atrauman C 10 cm x 10 cm (2 dressings in a pouch pack)

COMPOSITION
Clostebol Acetate …….0.5% w/w
Neomycin Sulphate …….0.5% w/w

DESCRIPTION

Clostagen is a combination of Clostebol Acetate, a potent tissue regenerator and Neomycin Sulphate, an antibiotic of first choice for topical application. HIGHLIGHTS • The tissue regenerator with an antibiotic
• Accelerates granulation tissue formation
• Creates conditions conducive for healing

CLINICAL PHARMACOLOGY

Clostabol Acetate is 4 chlorotestosterone which is a testosterone derivative inducing protein synthesis. Hence, Clostebol Acetate is an anabolic steroid bringing about protein synthesis. Clostebol Acetate stimulates repair of ulcers, lesions, skin dystrophies as a result of increased protein synthesis. Neomycin controls the infection which often interferes with the healing process. Thus, Clostagen, when applied topically is an effective treatment for faster healing of lesions involving both skin and mucosa. It exerts trophic and cicatrizing effects and reduces healing time when applied topically

Mechanism of action
Clostagen encourages in the injured tissues – the retention and fixation of nitrogen of mineral salts and of other substances necessary for protein synthesis.
This stimulates:
Transformation of fibrocytes into fibroblasts with, subsequent formation of collagen fibres.
It also accelerates the synthesis of acid mucopolysaccharides and their further transformation into neutral mucopolysaccharides which constitute the cementing substances.
Epithelial component of the cicatrisation process is rapidly influenced with a remarkable acceleration of the process of Re-epithelialization.

Association with neomycin:
Neomycin Sulphate is necessary to control the infection. Infection delays the restoration of tissue. Hence the presence of Neomycin Sulphate, in Clostagen.

INDICATIONS
• Episiotomy wounds
• Nipple Fissures
• Anal Fissures
• Circumcisions

CONTRAINDICATIONS
Clostagen is contraindicated in cases of known hypersensitivity to its components.

PRECAUTIONS
The continuous use of Clostagen should be avoided, especially in very early infancy. As the use of Neomycin involves a potential risk of ototoxicity and nepharotoxicity, it is not advisable to use Clostagen, on extensively affected areas which may increase absorption of the antibiotic.

ADVERSE REACTIONS
The use of topical products, especially if prolonged, can give rise to patient sensitization. Continued application for several weeks on large areas of damaged tissue my possibility, cause systemic effects such as hypertrichosis due to absorption of Clostebol.

APPLICATION PROCEDURE
? 1-2 applications daily. Spread a thin layer of cream on the affected area and cover with sterile gauze, if required.
? Baby should be fed only after 30mins.
? Before feeding the baby wash the nipples thoroughly with soap and water.

PRESENTATION
Clostagen cream is available in a 10 gm tube

Changes marked in OXOFERIN
FOR APPLICATION PROCEDURE BOOKLET REFER PPT ATTACHED FOR CURRENT PRICE OF MUCODYNE AND MUCOBRON CONTACT RESPECTIVE PRODUCT MANAGER AND ADD IN THE FILE NAMED PATIENT INFO

Post-op Dressing

DESCRIPTION

Cosmopor E is a self-adhesive wound dressing, which differs from traditional wound dressings with its novel combination of materials

FEATURES & BENEFITS
Wound contact layer which is water repellent, allows exudates to pass into the absorbent pad below, whilst it remaining absolutely dry. This prevents the dressing from sticking to the wound. Absorbent pad made up of 100% pure cotton wool, adapts well to the body contours and has excellent absorbency with cushioning properties. It allows absorption of blood and serous material in immediate post-operative stage. Cotton pad does not allow mild exudate to escape out Non woven support is permeable to both air and water vapour thus Cosmopor E does not interfere with the skin's natural functions, has rounded edges which prevents the dressing from becoming detached even when applied on difficult-to-retain areas. Wide, adhesive border ensures good closure. This together with the water repellent, non-woven covering layer gives reliable protection against the contamination of wound. Cosmopor E is coated with a hypoallergenic polyacrylate adhesive that is well tolerated by the skin.

INDICATIONS

• Post operative wound management
• Sterile dressing for minor injuries

APPLICATION PROCEDURE

Select the appropriate size as per the wound. Remove the paper backing and directly apply over the wound. No additional fixation required.

PRESENTATION
7.2 x 5 cm for Laproscopic surgery
15 x 8 cm for Gastrointestinal surgery
25 x 10 cm for Orthopedic surgery
35 x 10 cm for C-section, big size cuts

COMPOSITION
Silver suphadiazine USP ……… …………1.0%
Chlorhexidine Gluconate …………….. 0.2%
as Chlorhexidine gluconate solution I.P. 1.0

DESCRIPTION
C.S.S. - Chlorhexidine Gluconate 0.2% and Silver Sulphadiazine 1.0% act as broad spectrum anti-microbials for the prophylaxis of burn wound infection.

CLINICAL PHARMACOLOGY
Silver Sulphadiazine is active against gram –ve organisms
Chlorhexidine is active against both gram +ve & -ve organisms
Chlorhexidine is highly active against Staphylococcus aureus against which Silver Sulphadiazine is less effective.

HIGHLIGHTS
Clinically proven higher efficacy Helps reduce emergence of resistance

INDICATIONS
Burns (First, second and third degree burns) Open wounds prone to infection

CONTRAINDICATIONS
Known Hypersensitivity to its ingredients Premature neonates or neonates younger than 2 months of age

PRECAUTIONS
Impaired hepatic or renal function Pregnancy & lactation Discontinuance of the drug should be considered if an allergic reaction develops during therapy Avoid contact with eyes and ears

DOSAGE AND ADMINISTRATION
Following cleansing & debridement of the wound, the cream is applied with a sterile hand upto a thickness of 1 to 3 mm. Once daily application adequate, although some patients require a twice daily application.

PRESENTATION
CSS cream is available in
10 gm tubes
250 gm jars
500 gm jars

COMPOSITION
Each 1g vial of Eldcef contains:
Ceftizoxime sodium : 1 g (dry powder)
Each 250 mg vial of Eldcef contains:
Ceftizoxime sodium: 250 mg (dry powder)

DESCRIPTION
Ceftizoxime is a sterile, semisynthetic, broad-spectrum, betalactamase resistant cephalosporin antibiotic for parenteral (IV, IM) administration.

HIGHLIGHTS
(USPs) Broad spectrum third generation cephalosporin Lower MICs than Cefotaxime for several gram negative organisms Stable to even extended spectrum beta-lactamases Low resistance levels Highest anti-anaerobic action amongst cephalosporins Safer than ceftriaxone

CLINICAL PHARMACOLOGY
Eldcef contains Ceftizoxime, 3rd generation cephalosporin with a broad spectrum of activity against gram+ve, aerobic as well as anaerobic bacteria. Ceftizoxime acts by inhibiting the bacterial cell wall synthesis, thus exhibiting a bactericidal effect.
A serum half-life of approximately 1.7 hours was observed after IV or IM administration.
Ceftizoxime is 30% protein bound.
Ceftizoxime is not metabolized, and is excreted virtually unchanged by the kidneys in 24 hours. This provides a high urinary concentration.
Ceftizoxime achieves therapeutic levels in various body fluids, e.g., cerebrospinal fluid (in patients with inflamed meninges), bile, surgical wound fluid, pleural fluid, aqueous humor, ascitic fluid, peritoneal fluid, prostatic fluid and saliva, and in the following body tissues: heart, gallbladder, bone, biliary, peritoneal, prostatic, and uterine. In clinical experience to date, no disulfiram-like reactions have been reported with Ceftizoxime.
MICROBIOLOGY
Ceftizoxime is highly resistant to a broad spectrum of beta-lactamases (penicillinase and cephalosporinase), including Richmond types I, II, III, TEM, and IV, produced by both aerobic and anaerobic gram-positive and gram-negative organisms. Ceftizoxime is active against a wide range of gram-positive and gram-negative organisms.

INDICATIONS AND USAGE
• Lower Respiratory Tract Infections
• Urinary Tract Infections
• Meningitis
• Intra-Abdominal Infections
• Septicemia
• Skin and Skin Structure Infections
• Bone and Joint Infections
• Gonorrhoea
• Pelvic Inflammatory Disease

CONTRAINDICATIONS
Eldcef is contraindicated in patients who have known allergy to the drug.

PRECAUTIONS
Eldcef should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis. Eldcef should be administered with caution in patients suffering from renal impairment and hypersensitivity to penicillin. Renal and hematological status should be monitored, especially during prolonged and high dose therapy.

DRUG INTERACTIONS
Although the occurrence has not been reported with ceftizoxime, nephrotoxicity has been reported following concomitant administration of other cephalosporins and aminoglycosides. Pregnancy Pregnancy Category B: Ceftizoxime should be used during pregnancy only if clearly needed. Nursing Mothers Ceftizoxime is excreted in human milk in low concentrations. Caution should be exercised when ceftizoxime is administered to a nursing woman. Pediatric Use Safety and efficacy in pediatric patients from birth to six months of age have not been established. However there are studies available which report that Ceftizoxime is very safe even in premature babies and infants and do not cause any sever side effects.

ADVERSE REACTIONS
Eldcef is generally well tolerated. The most frequent adverse reactions are:
• Rash, pruritus, fever
• Transient elevation in AST, ALT & alkaline phosphatase, Transient eosinophilia, thrombocytosis
• Local burning, cellulitis, phlebitis with IV administration, pain, induration, tenderness, paresthesia
• Rare : Numbness, anaphylaxis, anemia, vaginitis etc.

DOSAGE AND ADMINISTRATION

Crepe Bandage

DESCRIPTION
Hospicrepe is crepe bandage made of superior quality combed yarn to give it excellent stretch and regain properties

FEATURES & BENEFITS
• Made of superior quality combed yarn
• Excellent stretch and regain properties for all kinds of compression & support
• Having being constructed from cotton & viscose it is dermophillic, permeable to air & does not slip
• Bandage is resistant to wound secretions, ointments & sweat
• A conspicuous indicator line for correct overlap, uniform tension better contrast & visibility
• Bandage can be washed and boiled or, if required sterilized

INDICATIONS
• For support & relief subsequent to removal of plaster casts.
• Supportive bandage for sprains, strains & injuries.
• As a securing bandage for grafts & pressure dressing for burns.

PRESENTATION
Hospicrepe 10 cm x 4 m Hospicrepe 15 cm x 4 m

Elastic Adhesive Bandage

DESCRIPTION
Hospiplast is elastic adhesive bandage made of lanolin

FEATURES & BENEFITS
• Hospiplast enjoys the very same features & benefits of Hospicrepe as it is made from the same crepe material.
• The presence of Lanolin makes it skin friendly & ensures an easy release
• A special technique of coating makes the bandage adhesive porous, due to which it is permeable to air and moisture making it skin tolerant. Coating is uniformly applied & not spread to the edge of the bandage (Prevents rucking.)
• Bandage is x-ray permeable. Line indicator (Accurate tension and correct overlap)Adheres reliably, can be moulded as per body contours (Remains in place till full use)

INDICATIONS
Suitable as a Postoperative dressing and for other indications (strapping).

PRESENTATION
Hospiplast 8 cm x 4/6 m Hospiplast 15 cm x 4 m

COMPOSITION
Hydrocolloid Dressing containing hydrocolloid matrix of pectin, gelatin and carboxymethylcellulose (CMC)

DESCRIPTION
Hydrocoll is a self-adherent absorbent hydrocolloid dressing. Hydrocolloid contains hydro active colloids. ‘Colloid’ means a substance that is integrated in a matrix when dispersed into its smallest constituents. Hydrocolloids are absorbent and can retain moisture. Polyurethane layer that is a semi-permeable film covers the hydrocolloids and functions as a bacteria and waterproof covering layer.

HIGHLIGHTS
• Allows natural healing by forming a moist gel and thereby maintaining a moist environment
• Stimulates cell proliferation and re-epithelization ? Promotes new blood vessel growth and collagen synthesis
• Facilitates autolytic debridement
• Significantly reduces itching, pain and requires less analgesia
• Highly effective than ‘traditional’ dressings
• Allows undisturbed wound healing with less frequent dressing changes

CLINICAL PHARMACOLOGY
Carboxymethylcellulose
- Allows high absorption of fluids
- Locks exudates and bacteria in the matrix

Polyurethane film on top for high MVTR
- Allows water to evaporate and fresh exudates to be absorbed giving selective permeability

Pectin gelatin for better absorption
- Sticks to the healthy skin only so that there is no adhesion to the moist wound

MECHANISM OF ACTION
After Hydrocoll is applied, wound secretions are absorbed by the hydrocolloids. Constituents of the dressing swell up and change into a gel, which expands into the wound, keeping it moist. The gel remains absorbent until the hydrocolloids are saturated. Saturation of the hydrocolloids is apparent from blistering of the dressing. When absorption occurs, the microcirculation in the wound area is improved at the same time so that body's own cleansing mechanisms are activated especially in the case of chronic wounds where the cleansing phase is stagnating. Hydrocoll absorbs the exudation from the wound and it swells up to form a blister. This condition creates a pressure on the wound that controls the level of exudation from the wound. In the granulation phase, the moist wound environment under Hydrocoll stimulates the activity of the fibroblasts in particular, which play a crucial role in initiating tissue production. Division and migration of the epithelial cells are supported in the epithelialization phase. Hydrocoll maintains the moist wound environment thus preventing the granulation tissue from drying out without the risk of exudates accumulating in the wound even during prolonged application. During epithelialization phase, division and migration of epithelial cells are supported by moist environment. If no complications occur then Hydrocoll can be left on the wound for a few days during this phase until epithelialization is complete. The bacteria and waterproof covering layer acts as a reliable barrier against microorganisms and protects the wound against soiling and moisture. Even the patient can take a shower with the dressing.

INDICATIONS
• Bed sores
• Superficial abrasions
• Ulcers mainly decubitus/venous/arterial

CONTRAINDICATIONS
No listed contraindications

APPLICATION PROCEDURE
• Remove one half of the backing paper
• Place exposed side of Hydrocoll on the wound. Remove second half of the backing paper and apply Hydrocoll fully.
• After applying Hydrocoll, hold the dressing in place with your palm for one minute to ensure optimum adherence.
• Relieve pressure on the wound (in case of pressure sore).

Frequency of change The frequency depends on the level of exudation and the stage of healing. It can be left on the wound for 3-5 days. (The blister formation is an indicator for the dressing change)

PRESENTATION
Hydrocoll 10 x 10 cm,15 x 15 cm Hydrocoll Thin 10 x 10 cm

DESCRIPTION
Molicare Dry Plus is an all in one-incontinence brief with dry plus fluid distribution layer and super absorbent core with wetness indicator.

FEATURES AND BENEFITS
Shape of absorbent pad provides reliable leakage protection as well as protects skin against rewetting. Its shape allows greater freedom of movement. Inner cuffs - This wetness repellent anti-leak cuff provides added protection against leakage at the sides. Fluid distribution layer which is made up of dry plus fibre, guides wetness rapidly in to the new absorbent core, safely away from skin, keeping it comfortably dry. Elastic outer foil provides the perfect fit, fitting the body contours perfectly. Soft elastic threads offers flexible leg gathers with perfect fit and additional leakage protection without pinching. Wetness indicator - The elastic foil backing has a built in wetness indicator. When the word “Molicare” dissolves then it indicates that its time to change Molicare which is very convenient for the patient to understand. Frontal tape makes it possible to re-open and close the adhesive tape several times without difficulty Absorbent core absorbs and reliably holds 10 times its weight in fluid and keeps the wetness away from skin.

INDICATIONS
Specially designed for patients with severe urinary incontinence, highly dependent patients (due to surgery, geriatric population).

Bed protection sheet

DESCRIPTION
Molinea Plus are underpads with an absorbent core of cellulose fluff.

FEATURES & BENEFIT
• Waterproof, non-slip foil backing sealed edge to edge.
• Absorbent core of cellulose fluff with high absorbency.
• Fluid - dispersing tissue layer, which helps to stay dry.
• Non-woven top layer covering the entire surface. All the above advantages make the patient feel comfortable and hygienic.

INDICATIONS
• As an additional bedding protection
• Can also be used in conjunction with other body worn products
• Can also be used during surgical procedures in the operation theatre Excellent as baby's bedding protection

Non-woven dressing retention

DESCRIPTION
Omnifix E is a self adhesive, non-woven fabric for complete cover dressing retention

FEATURES & BENEFITS
• Omnifix E is extremely soft as well as permeable to air and water vapour thus it is well tolerated to the skin even after prolonged application.
• A hypoallergenic adhesive enhances the non-irritant properties of Omnifix E. This adhesive is well tolerated even by the patients with sensitive skin.
• Omnifix E has an excellent adhesive strength yet it can be removed painlessly without leaving residues.
• The non-woven support that is elastic in width enables Omnifix E to be securely and smoothly applied to joints and angular parts of body too.
• Omnifix E does not absorb X-rays (radiolucent) thus can be left in place for radiography.
• Omnifix E is very easy to use; a wave shaped punch cut helps while removing the covering paper.

INDICATIONS
• Complete dressing retention on any part of the body
• For securing probes and catheters

APPLICATION PROCEDURE
Cut the required size Fold over the narrow side of the release paper backing, pull off and stick on Omnifix-E is only stretchable crosswise but not lengthwise. Take this into account while applying Now push over the dressing. Do not pull

PRESENTATION
Omnifix E 5 cm x 10 m rolls Omnifix E 10 cm x 10 m rolls

OXOFERIN

COMPOSITION
Each 30 ml of Oxoferin contains:
Tetrachlorodecaoxide in an aqueous base - q.s.

HIGHLIGHTS (USPs)
• A unique concept in wound healing, which is based on the activation of
macrophage system
• A moist therapy which contains the bioactivated oxygen carrier TCDO i.e.
Tetrachlorodecaoxide anion complex
• Thus an aqueous solution to be used locally to promote wound healing

CLINICAL PHARMACOLOGY
OXOFERIN is an aqueous solution containing Tetrachlorodecaoxide, a nonmetallic
bio-catalytically activated oxygen carrier. It is an effective wound healing
agent.
Upon application, Tetrachlorodecaoxide penetrates the tissue where it stimulates
phagocytosis, leading to a rapid wound cleansing and effective local defense
against infections.
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Activated by bio-catalysis, it is broken down into the physiological metabolitesoxygen
& chloride. This results in an increase of the partial oxygen pressure in
the wound. Formation of bright red granulation tissue with an extremely good
blood supply is accelerated, leading to a significant faster epithelialisation and
formation of smooth scars.
Oxoferin containing TCDO is used for local application to promote wound
healing. The following pharmacological effects are significant for the therapeutic
use of oxoferin in the topical treatment of wounds.
a.) Increasing O2 tension in hypoxic situations.
b.) Increasing phagocytic activity.
c.) Antimicrobial activity.
Increasing O2 tension in hypoxic situations
In vitro & vivo experiments demonstrate the oxygen donor effect of TCDO. In
vitro experiments show that TCDO in the presence of haem proteins leads to
oxygen release. This released oxygen, leads to an elevation of O2 pressure in
the hypoxic tissue regions.
Increasing phagocytic activity
Oxoferin intensifies the phagocYte response and therewith activates the wound
macrophages which can only take on their key function in all three at ages of
wound healing when they are activated:
• Wound cleansing and resistance to infection
• Wound granulation with capillary multiplication and collagen synthesis
• Epithelial closure
Antimicrobial activity
The bactericidal action of TCDO has been demonstrated in vitro. The incubation
of different organisms with TCDO and various proteins in suspension tests
provide an intensification of the TCDO bactericidal action.
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The antimicrobial effect of TCDO appears not to be based on modifications of the
external membrane of the bacterial cell.

INDICATIONS AND USAGE
To promote wound healing in the following wounds :
• Infected wounds
• Delayed post-traumatic wound healing
• Delayed wound healing after amputation
• Decubitus (sacrum, buttocks, heels)
• Tissue preparation for skin graft
• Chronic leg ulcers combined with venous failure
• Delayed wound healing after third degree burns.
• Diabetic ulcers
• Arterial ulcers

CONTRAINDICATIONS
No specific contraindications. Not established in Pregnancy & Lactation.

PRECAUTIONS
General
Do not apply OXOFERIN in conjunction with other wound healing drugs.
Chronic Toxicity
Oxoferin was tested for local tolerance during periods of 13 weeks in dogs and 3
weeks in rabbits. Animals with normal and sacrificed skin were used. With
exposure for 4-6 hours per day. Doses of up to 12-ml/kg-body weight were
administered with not the slightest local or systemic toxic reactions.
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In two standard skin tests (patch tests), oxoferin induced no contact allergy
reactions in dermatological patients with and without wounds and with and
without a known history of contact allergy (n=81).
Drug Interactions
Because of its mode of action oxoferin should be used as a monotherapy.
Additional topical therapeutic agents should always be avoided. Studies have
shown that local therapeutics, especially local disinfectants and pigment
solutions such as brilliant green, gentian violet, fuchsine, malchite green can lead
to an inactivation of the active substance TCDO. Besides most local disinfectants
counteract oxoferin’s promotion of granulation.

ADVERSE REACTIONS
Hypersensitive Skin Reactions
Generally, well tolerated.
However the following symptoms may occur occasionally in the wound area at
the start of treatment and should be considered as an indication that the wound
is starting to heal.
Updated as on 14 October 2005 Page 4 of 4
Erythema, itching, or burning & in rare cases slight pain.
Because of the completely novel mode of action of oxoferin, physiological
wound healing signs can be intensified. If treatment is continued consistently, the
signs will stabilize after a few days.
Slight pain can be interrupted as a sign that the wound is starting to heal
(Exudative pressure on nerve endings).
In severe cases, the wound can be remoistened with physiological saline.
Reddening of wound’s border area:
A reddening of the area immediately surrounding the wound as the treatment
commences is a sign that the perfusion in the wound is starting to improve.
Greenish wound secretion with ulcus cruris & decubitus
In the initial phase of wound healing process, there may possibly be an increased
greenish wound secretion signaling the start of phagocytic activity. An overdose
is most likely the cause, if, after an initial wound cleansing, further treatment
results in an increased green smearing of the wound, increased secretion &
discoloration of the granulation tissue.
If amount of oxoferin is reduced, the wound quickly regains a normal healthy
appearance.
The moist wound treatment principle should not be deviated from under any
circumstances (eventually alternating oxoferin with physiological saline)
Spontaneous bleeding:
If spontaneous bleeding occurs on contact with wound tissue it is a positive sign
that capillaries are starting to multiply.
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When the wound grows larger
An apparent enlargement of the wound, as was often the case in the presence of
atrophic blanche, results from the phagocytic digestion of tissue, no longer
capable of regeneration.
When oxoferin is used, there is a speedy demarcation between dead and
healthy tissue. This effect is due to increased phagocytosis by TCDO.

OVERDOSAGE
After initial wound cleansing, a greenish smear may appear if oxoferin is used in
an overdose. This disappears when the amount of Oxoferin is reduced.
Oxoferin is not toxic when used according to directions.

DOSAGE AND ADMINISTRATION
Initial Dosage
OXOFERIN (5-10 ml) should be applied to the wound twice daily or as required.
The amount applied depends on the size of the wound. The application of a
moistened cotton compress has proven effective. A simply formed cotton
compress of 10 x 10 cm requires 5 ml oxoferin in order to be correctly prepared
for treatment of the wound. Although 5-10 ml is generally sufficient. The amount
of 10 ml per treatment may be exceeded with large wound areas.
The dosage may be reduced to once daily in visibly progressing wound healing,
whereby the moist treatment should not be deviated from (Possibility of using
physiological saline instead of the second treatment).
Duration of treatment should not exceed 6 weeks, although prolonged treatment
may prove necessary in exceptional cases.
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Prior to application, clean the surrounding area. OXOFERIN may be applied, if
necessary, repeatedly without having to change dressings several times a day by
pouring it directly on to the dressing.
When the wound is dirty, the dose can be doubled during the first 1-2 days. The
bandages of highly exudative wounds should be changed twice daily to remove
liquefied necrosis. The excessive secretion levels return to normal after treatment
with oxoferin.
Deep decubital ulcers should be packed loosely, especially in the sacral region.
In these cases the wound should be moistened twice a day through the
compresses or dressing.
Maximum Dosage
Even with systemic administration, which was studied within the context of
toxicological investigation, no toxic reactions were observed with the maximum
physiologically sensible administration volume (50ml/kg body weight).
With all routes of administration there were no deaths even with the maximum
applicable dose.

HOW SUPPLIED
OXOFERIN is available in a bottle of 30 ml.
Updated as on 14 October 2005 Page 7 of 7

FEATURES & BENEFITS

• Rhena Cast is an easy to apply synthetic cast, which renders a strong to extremely strong stabilization.
• It consists of a knitted glass fibre fabric impregnated with a polyurethane resin, which is activated by water and can be applied easily and fast.
• Even coating of resin provides a good layer of cohesiveness/bonding
• It allows quick unrolling due to additional impregnation of bandage surface
• It provides high degree of mouldability due to flexible support material
• A special colour print impregnation prevents the colour from fading out Rhena cast is supplied in hermetically sealed foil pouches. After removal from the package and submersion in water, the material hardens within 3 to 5 minutes under the release of heat. The cast can bear load in just 30 minutes. The finished cast can be cut with a plaster saw.

INDICATIONS
• For strong to very strong stabilization after fractures
• Suitable for total immobilization
• For preparation of orthopedic splints and securing instruments , probes

PPLICATION PROCEDURE
• Put on gloves
• Protect the entire body area being treated with a suitable padding material
• Open the foil pack just prior to use
• Immediately immerse Rhena Cast completely in the water bath, and activate by squeezing several times
• Remove Rhena Cast from the water bath
• Quickly drain the excessive water
• Apply the bandage without traction power
• Contact of the bandage with skin, clothing or other objects should be avoided

PRESENTATION
Product Size Colour option Rhena Cast 10 cm Length 3.6 m White Rhena Cast 12.5 cm Length 3.6 m White Rhena Cast 10 cm Length 3.6 m Blue Rhena Cast 12.5 cm Length 3.6 m Blue Rhena Cast 5 cm Length 3.6 m Red

Plaster Of Paris (POP) bandage

FEATURES & BENEFITS
• Safix plus becomes moist very quickly and evenly due to its porous structure
• It is made of high quality natural gypsum impregnated gauze fabric which gives the bandage
• excellent moulding properties
• It provides ideal creaminess during casting
• Has a short immersion time (4-5 secs) so bandage can be applied rapidly
• Has good powder retention properties i.e very low powder loss hence less number of bandages per application with better cast strength

Other Highlight Points:
• Offers 11 % extra length than the commonly available POP bandages
• Moulding time of 2 – 3 minutes
• Bandage sets after 5 minutes
• Can be subjected to load bearing after only 30 minutes
• High final strength Is available in 2s pack for quick application

INDICATIONS
For immobilization after fractures, & Orthopaedic corrections for treating joint & bone disorder

PRESENTATION
• SafixPlus 10 cm x 3 m
• SafixPlus 14 cm x 3 m

Plaster Of Paris (POP) bandage

FEATURES & BENEFITS
SAFIX offers the following major benefits:
• Made of Lino gauze - Provides the bandage a better stability
• Very low “dry powder”** & “wet powder”** loss - Less number of bandages per application with better cast strength
• Absorbs water faster - Helps in faster applications
• Ideal creaminess - Helps in molding a professional looking cast
• Has more powder per square cm - Helps in making stronger casts

INDICATIONS
Stabilization Other benefits:
• Short dipping time
• Low plaster loss
• High final strength
• Light weight ,durable with high cast strength
• White cast with smooth finish and excellent mouldability
• Low exothermic reaction (Less release of heat)
• Low level of dust on removal by cast saw
• X-ray permeable
• Setting time is approx. 3 – 3 ½ mins
• Early strength for Windowing & Bivalving – 10 mins after dipping

FOR OPTIMUM RESULTS FOLLOWING USAGE INSTRUCTIONS HAVE TO BE FOLLOWED
• Right water depth: Should be 10 cms deeper then the width of the widest bandage used
• Right water temperature: 20°c – 25°c (68° F-77° F)
• Right dipping technique: Holding the bandage loosely in hand, immerse completely at an angle of 45° for one second per metre of bandage
• Right squeeze: Hold the bandage at both ends and squeeze gently to expel excess water
• Bandages are fully soaked after brief immersion, the finished cast has an early weight bearing after approx. 30mins,and fully sets after 24 hrs

PRESENTATION
Safix 10 cm x 2.7 m Safix 15 cm x 2.7m

COMPOSITION
Each 20 gm tube of SALUTYL Ointment contains: Collagenase - 250 units per gram of White Soft Paraffin I.P.

HIGHLIGHTS Proven Efficacy
• Ensures rapid removal of slough
• Promotes early granulation & re-epithelialisation
• Reduces pus, odour, necrosis, inflammation
• Reinforces body’s natural self-debridement process Safe
• Non-toxic
• Does not harm healthy tissue
• Minimizes scar formation Simple
• Simple to use
• Once daily application

CLINICAL PHARMACOLOGY
The enzyme collagenase is derived from fermentation of clostridium histolyticum. It posseses the unique ability to digest collagen in the necrotic tissue. Collagen accounts for 75% of the dry weight of the skin tissue. The ability of collagenase to digest collagen at the physiological pH and temperature makes it particularly effective in the removal of debris from the wound. Collagenase thus contributes towards the formation of granulation tissue and subsequent epithelization of dermal ulcers and severely burned areas. Collagen in healthy tissue or in newly formed granulation tissue is not attacked.

Debridement process with Salutyl Ointment
1. Pressure and its corollary, impaired blood flow, produce a necrotic area highly susceptible to infection. Here, strands of collagen anchor the debris to wound.
2. Antibiotic powder/aerosol combats infection, while Salutyl ointment digests the strands of necrotic collagen anchoring debris to the base of the wound.
3. After debridement, new cells begin to form on the wound surface. Use of Salutyl ointment should be terminated when debridement of necrotic tissue is complete and granulation is well established.
4. Epithelial cells, blood vessels and granulation tissue continue to fill in the ulcer crater. The therapeutic usefulness of collagenase (salutyl) ointment is of great importance in the treatment of decubitus ulcers. Collagenase is an effective and safe debriding agent, which promptly attacks necrotic matter and fibers of denatured collagen, paving the way for the formation of granulation tissue, epithelialisation and healing. Data indicate that the reduced rate of necrosis and the increase in granulation tissue, in particular, were steady and statistically highly significant. Also, improvement occurred in such signs as pus, odour, and inflammation. An additional beneficial effect of collagenase ointment in patients with superficial dermal ulcers seems to be the reduced incidence of hypertrophic scarring; the scar is rather thin and even. This reduction in scarring probably is related to the fact that epithelization of these ulcers proceeds from a completely debrided base. Another positive aspect of collagenase therapy is the ease of application of the ointment. Because good nursing care is mandatory for the reduction of decubitus ulcers, the convenience of once daily application is evident, especially when the nurse/patient ratio is higher than desirable. The findings of this study indicate collagenase (salutyl) ointment, a collagenolytic debriding agent, is an excellent addition to the therapeutic and nursing management of decubitus ulcers.

INDICATIONS AND USAGE
For debriding:
• Chronic dermal ulcers &
• Severely burned areas Where it helps in cleaning the necrotic debris and contributes to the granulation tissue formation. CONTRAINDICATIONS Patients who have shown local or systemic hypersensitivity to collagenase.

PRECAUTIONS
• The appropriate pH range of collagenase is 6 to 8. Higher or lower pH conditions will decrease the enzyme’s activity & therefore appropriate precaution should be taken.
• When use of substances such as detergents, heavy metal ions etc is suspected, the site of application should be carefully cleansed by repeated washings with normal saline before applying the ointment.
• A slight transient erythema has been noted occasionally in the surrounding tissue, particularly when SALUTYL Ointment was not confined to the lesion. Therefore the ointment should be applied carefully within the area of the lesion. Drug Interactions Should not be used with substances such as detergents, heavy metal ions etc. Cleansing solutions like hydrogen peroxide, Dakins solution and sterile saline are compatible with Salutyl ointment.

ADVERSE REACTIONS
Generally, SALUTYL OINTMENT is well tolerated. No allergic sensitivity or toxic reactions have been noted in the recorded clinical investigations.

OVERDOSAGE
Action of the enzyme may be stopped, should this be desired, by the application of Burow’s solution USP (Ph: 3.6-4.4) to the lesion.

DOSAGE AND ADMINISTRATION
SALUTYL Ointment should be applied once daily (or more frequently if the dressing becomes soiled, as from incontinence) in the following manner:
Step 1: Prior to application, the lesion should be cleaned of debris and digested material by gently rubbing with gauze pad saturated with hydrogen peroxide followed by normal saline.
Step 2: Whenever infection is present, an appropriate topical antibiotic powder should be applied to the lesion prior to the application of SALUTYL Ointment. Should the infection not respond, therapy with SALUTYL Ointment should be discontinued until remission of the infection.
Step 3: SALUTYL Ointment should be applied directly to deep lesions with a wooden tongue depressor or spatula. For shallow lesions, SALUTYL Ointment may be applied to sterile gauze pad, which is then applied to the wound and properly secured.
Step 4: All excess ointment should be removed each time dressing is changed. Use of SALUTYL Ointment should be terminated when debridement of necrotic tissue is complete and granulation tissue is well established.

PRESENTATION
Salutyl ointment is available in a tube of 20 gm.

COMPOSITION
Calcium Alginate Dressing

DESCRIPTION
Sorbalgon is a gel forming non-woven dressing made up of high quality 100% calcium alginate fibres and is a purely natural product. The raw material for the production of the fibres is alginic acid, which is extracted from the marine brown algae.

HIGHLIGHTS
• Guarantees maximum conformability and close contact with the wound bed.
• Sorbalgon has a high absorption capacity, which assures proper wound cleansing.
• Sorbalgon transforms into a gel, which entraps exudates and creates a moist wound environment.
• Does not stick to the wound & causes minimal pain while changing
• Does not harden on standing or hurt the healing tissue

CLINICAL PHARMACOLOGY
Calcium alginates are polysaccharides derived from seaweed. Calcium alginate fibers transform into a gel upon contact with the wound secretion. Calcium ions exchanges with sodium ions to initiate clotting process. Sorbalgon acts as a haemostatic agent helps control bleeding in acute wounds. Mechanism of Action Once Sorbalgon is placed on the wound, it comes in contact with sodium salt such as those found in the blood and wound secretions. Sorbalgon's fibres swell and transforms into a moist absorbent gel, which will fill the wound but does not adhere to the wound. The gel forms a physical barrier against secondary contamination of the wound. The close adaptation of Sorbalgon to the wound surface means that bacteria are absorbed from the depth of the wound and enclosed securely in the gel structure. This leads to effective reduction in bacteria and helps to avoid recontamination and cleans the wound rapidly. Sorbalgon's gel like structure also acts like a moist dressing which prevents the wound from drying. Such microclimate is always favourable for wound healing that promotes the formation of granulation tissues and keeps the wound surface supple. Because of the gel formation, Sorbalgon does not stick to the wound and dressing changes are painless. Complete conversion of the calcium alginate fibres to a gel needs adequate secretion. If a deep wound has very low secretions then Sorbalgon has to be moistened with Ringer's solution. Any fibres remaining in the wound can be washed out with Ringer's solution or removed with forceps

INDICATIONS
For exudating wounds, superficial and deep
• Chronic deep & lacerated wounds
• Diabetic/Venous/Arterial/Decubitus ulcers
• Carbuncles / Abscesses
• Accidental injury at difficult site
• Skin graft donor sites
• Vein graft wounds

CONTRAINDICATIONS
No contraindications

APPLICATION PROCEDURE
• Place Sorbalgon on or pack into the wound. Loosen Sorbalgon in several layers before packing it in the wound.
• For dry wounds, Sorbalgon can be first moistened with Ringer's solution.
• Change the dressing once Sorbalgon has been fully transformed into a gel. The body will degrade any fibres remaining in the wound. Irrigate wound with Ringer's solution if necessary.
• Cover with cotton gauze if required. Secure with an adhesive non-woven sheet dressing (e.g. Omnifix E) or any other bandage.

Frequency of change Frequency of the dressing change depends on the individual wound. During cleansing phase: once/twice daily or depends on degree of exudation. Later as granulating commences: 2/3 daily. Sorbalgon has to be changed after complete transformation into a gel.

PRESENTATION
Sorbalgon 10 x 10 cm Sorbalgon T 30 cm

COMPOSITION
Super Absorbent Polyacrylate Dressing

DESCRIPTION
TenderWet is a multi-layered wound-dressing pad, which contains following components:
• Central component is a super absorbent poly-acrylate (SAPA) with a greater capacity to absorb protein rich wound exudates with irrigating properties.
• Outer cover of knitted fabric which gives high flexibility to Tender Wet. This ensures direct and complete contact with the wound bed, which is required for fluids, exudate exchange (even in deep wounds). TenderWet plain has got the central component with an outer cover on both sides.

HIGHLIGHTS
• Ringer’s solution facilitates the softening and debridement of necrotic tissue.
• TenderWet has a unique self-acting rinsing mechanism in which wound exudate displaces Ringer's solution from the dressing pad to the wound.
• The super absorbent poly-acrylate absorbs all wound debris from the wound bed.
• TenderWet further conditions the wound even after a surgical debridement
• TenderWet maintains a continous moist environment

CLINICAL PHARMACOLOGY
Ringer’s solution loosens the debris SAPA forms a covalent bond with proteineous exudate and absorbs and locks bacteria. It also inhibits the MMP-2, MMP-9 activity found in chronic wounds.

Mechanism of Action
The central super absorbent poly-acrylate core of TenderWet is activated before use with appropriate volume of Ringer solution. After applying activated TenderWet over the wound, it ensures sustained release of Ringer's solution into the wound. This permanent inflow of Ringer's solution softens and loosens necrotic tissue actively. At the same time, bacterially contaminated wound exudate gets absorbed reliably and bound into the absorbent care. This exchange function occurs because the super absorber has a greater affinity for protein containing wound exudate than for salt containing solutions (Ringer's solution) so the wound exudate displaces the Ringer’s solution from wound pad to the wound. Thus TenderWet continuously renews the film of Ringer's solution in the wound. This keeps the wound moist and at the same time TenderWet absorbs bacteria detritus, toxins from the wound bed rapidly and helps to keep wounds irrigated and moist.

INDICATIONS
• Diabetic ulcers
• Pressure sores
• Venous/ Arterial ulcers
• Clinically infected wounds
• After surgical debridement for wound conditioning CONTRAINDICATIONS No contraindications.

APPLICATION PROCEDURE
• Open the pack of TenderWet and activate the TenderWet with appropriate amount of Ringer's solution.
• Wait for 2 minutes
• Cover the entire wound with TenderWet, ensuring close contact with the wound bed. • Secure with an adhesive non-woven sheet dressing (e.g. Omnifix E) or with a gauze bandage. TenderWet can be changed after 12 hours

PRESENTATION
TenderWet 7.5 x 7.5 cm 10 x 10 cm

COMPOSITION
Tixor Plus 250 mg
Each vial contains: Ceftriaxone Sodium USP equivalent to Ceftriaxone .. 250 mg Tazobactam Sodium equivalent to Tazobactam ……31.25 mg
Tixor Plus 500 mg
Each vial contains: Ceftriaxone Sodium USP equivalent to Ceftriaxone … 500 mg Tazobactam Sodium equivalent to Tazobactam …..62.5 mg
Tixor Plus 1000 mg
Each vial contains: Ceftriaxone Sodium USP equivalent to Ceftriaxone …1000 mg Tazobactam Sodium equivalent to Tazobactam …..125 mg

DESCRIPTION
Ceftriaxone Sodium is a sterile, semisynthetic, broad spectrum cephalosporin antibiotic. Tazabactum sod. is a penicillinic acid sulfone Beta-lactamase inhibitor with a structure similar to that of sulbactum and clavulanic acid.

HIGHLIGHTS
• Ceftriaxone is a parenteral third-generation cephalosporin with a long elimination half-life which permits once-daily administration
• ESBL’s are susceptible to beta lactamase inhibitors like tazobactam
• The combination of ceftriaxone and tazobactam gives a broader spectrum of action and synergistic action. Tazobactam forms a more stable complex with BL and hence better inhibition
• Tazobactam inhibits a wide spectrum of Beta Lactamases

CLINICAL PHARMACOLOGY
Ceftriaxone
Ceftriaxone is a 2-aminothiazolyl methoxyimino third generation cephalosporin derivative. Ceftriaxone offers good activity against gram-negative organisms with reasonable activity against gram-positive organisms. Ceftriaxone is a third-generation cephalosporin, and is characterized by pharmacological properties which are unique for this class of antibiotics.
Tazobactam
Tazobactam is a penicillinate sulfone, structurally related to sulbactam. Being a beta lactamase inhibitor, it is synergistic with many beta lactamase labile drugs such as penicillins and cephalosporins. Tazobactam inhibits all beta lactamases inhibited by clavulanic acid, but in addition it also has some activity against chromosomally mediated (or derepressed) enzymes of Morganella morganii, Citrobacter freundii, Enterobacter cloacae, Serratia marcescens and Pseudomonas aeruginosa. Tazobactam also appears to be a weaker enzyme inducer than other beta lactamase inhibitors. The combination of Tazobactam and Ceftriaxone is active against all the organisms sensitive to Ceftriaxone. In addition, it demonstrates synergistic activity (reduction in MICs for the combination versus those of each component) in a variety of organisms.

INDICATIONS
Tixor Plus is indicated for the treatment of the following infections:
• Treatment of nosocomial infections & surgical prophylaxis
• Bacterial Septicemia
• Lower Respiratory Tract Infections
• Meningitis
• Skin and Soft Tissue Infections like Cellulitis
• Chronic Suppurative Bacterial Otitis Media
• Intra-abdominal Infections like Peritonitis, Cholecystitis
• Bone & Joint Infections like Osteomyelitis
• Urinary Tract Infections (Complicated by underlying urological abnormalities)
• Sexually Transmitted Diseases like gonorrhoea, chancroid, syphilis
• Infections in dialysis unit. The preoperative administration of Tixor Plus may reduce the incidence of postoperative infections in patients undergoing surgical procedures.

CONTRAINDICATIONS
Tixor Plus is contraindicated in patients with known allergy to penicillin or any other ingredients of the combination.

PRECAUTIONS
The nephrotoxic potential of ceftriaxone is similar to that of other cephalosporins. Patients with renal failure normally require no adjustment in dosage when usual doses of ceftriaxone are administered but concentrations of drug in the serum should be monitored periodically. If evidence of accumulation exists, dosage should be decreased accordingly. Dosage adjustments should not be necessary in patients with hepatic dysfunction; however, in patients with both hepatic dysfunction and significant renal disease, dosage should not exceed 2 gm daily without close monitoring of serum concentrations. Alterations in prothrombin times have occurred rarely in patients treated with ceftriaxone. Patients with impaired vitamin K synthesis or low vitamin K stores (e.g. chronic hepatic disease of malnutrition) may require monitoring of prothrombin time during Tixor Plus treatment. Vitamin K administered (10 mg weekly) may be necessary if the prothrombin time is prolonged before or during the therapy. Prolonged use of ceftriaxone may result in overgrowth of nonsusceptible organisms. Careful observation of the patient is essential. Tixor Plus should be discontinued in patients who develop signs and symptoms suggestive of gallbladder disease.

WARNINGS
Serious or occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam therapy. These reactions are more likely to occur in individuals with a history of hypersensitivity reactions to multiple allergens. If an allergic reaction develops, the drug should be discontinued and appropriate therapy instituted. This product should be given with caution to patients with hypersensitivity to penicillin. Pseudomembranous colitis has been reported with the use of cephalosporins (and other broad-spectrum antibiotics), therefore, it is important to consider its diagnosis in patients who develop diarrhoea in association with antibiotic use.

PREGNANCY AND LACTATION
There are no adequate and well-controlled studies in pregnant women and the drug should be used during pregnancy only when clearly needed. Low concentrations of ceftriaxone are excreted in human milk. No risk to nursing infants has been reported but caution should be exercised when ceftriaxone is administrated to nursing women.

ADVERSE REACTIONS
Tixor Plus is generally well tolerated. Local Reactions: pain, induration and tenderness, phlebitis. Hypersensitivity: rash (1.7%). Less frequently reported (<1%) adverse reactions include pruritus, fever or chills. Hematologic: eosinophilia, thrombocytosis and leukopenia Gastrointestinal: diarrhea (2.7%). Less frequently reported (<1%) include nausea or vomiting, and dyspepsia. Hepatic: elevations of AST or ALT. Less frequently reported (<1%) include elevations of alkaline phosphatase and billirubin. Renal: elevations of the BUN. Central Nervous System: headache or dizziness have been reported occasionally (<1%).