0.045% DAC N-055 a choice for poor Afghan surgical patients?
KeywordsOsteomyelitis Tissue Infection Wound Closure Open Method Open Fracture
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.
Disclosure of interest
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.