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IODOSORB Ointment and Paste

Cadexomer Iodine Ointment and Unit Dose Paste

Overview

Description

Cadexomer Iodine Ointment

IODOSORB ointment is a sterile antibacterial agent.  1 gram of IODOSORB ointment contains: Cadexomer iodine 500mg, equivalent to: Cadexomer 491mg, iodine 9mg. IODOSORB ointment also contains poloxamer, polyethylene glycol 400, polyethylene glycol 4000.

Cadexomer Iodine Paste

IODOSORB paste is a sterile antibacterial agent1 gram of IODOSORB contains: Cadexomer iodine 600mg, equivalent to: Cadexomer 591mg, Iodine 9mg. IODOSORB also contains polyethylene glycol 300, polyethylene glycol 1500.


Features and Benefits

Features Benefits
IODOSORB has been shown to disrupt and substantially eradicate mature biofilms of P. aeruginosa in vitro 1, 2 Disrupts and eradicates mature biofilms that can delay wound healing.
Effective desloughing 3-6 Helps cleanse the wound bed and prepare for effective healing.
High absorption capacity 3,4,6-9 Assists with autolytic debridement by absorbing excess fluid, slough and debris. 6, 10-12
Sustained, local, slow release of iodine 4, 12-14 which has broad spectrum antimicrobial activity in vitro including MRSA 6, 7, 9, 12, 14, 15 Accelerates healing. 3, 4, 7, 8, 10, 11
Reduces pain and edema. 3, 4, 7, 10-12, 13, 16
Changes colour to indicate when dressing change is required. 13


Indications

IODOSORB is indicated for the topical treatment of chronic exuding wounds such as leg ulcers.

IODOSORB may be used on infected wounds.  Where the product is used on infected wounds the Infection should be inspected and treated as per local clinical protocol.

IODOSORB may be used under compression therapy.


Contraindications

Do not use on dry necrotic tissue or on patients with a known sensitivity to any of its ingredients.

Do not use on children, pregnant or lactating women or people with thyroid disorders or renal impairment.

 

Ordering Information

IODOSORB Ointment 

Product # Format Unit of Measure
66060630 10 g tube 4 tubes/box
66060631 20 g tube 2 tubes/box
66060632 40 g tube 1 tube

  

IODOSORB Paste

Product # Format Unit of Measure
66060633 5 g (4 cm x 6 cm) 5 dressings/box
66060634 10 g (6 cm x 8 cm) 3 dressings/box
66060635 17 g (8 cm x 10 cm) 2 dressings/box


 

References

  1. Smith & Nephew Research Centre Work Report #WRPTSG015- 07-003.

  2. Phillips, P. L. et al., Effects of Antimicrobial Agents on an (in vitro) Biofilm Model of Skin Wounds. ADVANCES IN WOUND CARE (2010)1: 299-304.

  3. Sundberg J and Meller R. A retrospective review of the use of cadexomer iodine in the treatment of chronic wounds. Wounds (1997), 9(3): p 68-86.

  4. Ormiston MC et al., A randomised comparison of cadexomer iodine and a standard treatment in out-patients with chronic leg ulcers. In Cadexomer Iodine JA Fox, H Fischer eds. (1983) 63-69.

  5. Hansson C. The effects of cadexomer iodine paste in the treatment of venous leg ulcers compared with hydrocolloid dressing and paraffin gauze dressing. Int J Dermatology (1998) 37: p390-396.

  6. Troeng T et al., In Cadexomer iodine. Fox JA, Fischer H (eds) (1983) p43-50.

  7. Lindsay G et al., A study in general practice of the efficacy of cadexomer iodine in venous leg ulcers treated on alternate days. Acta Therapeutica (1986) 12, p141-148.

  8. Drosou A, Falabella A, Kirsner MD. Antiseptics on Wounds: An area of controversy. Wounds (May 2003), Vol 15 no 5, p149-166.

  9. Johnson A. A combative healer with no ill effect. IODOSORB in the treatment of infected wounds. Professional Nurse (Oct 1991) p60-64.

  10. Holloway GA, Johansen KH, Barnes RW et al., Multicenter trial of cadexomer iodine to treat venous stasis ulcer. West J Med, (1989 Jul), 151, p35-38.

  11. Moberg S et al., A randomised trial of cadexomer iodine in decubitus ulcers. J Am Geriatrics Soc. (1983).31 p462-465.

  12. Skog E et al., A randomised trial comparing cadexomer iodine and standard treatment in the outpatient management of chronic venous ulcers. Br J Dermatology (1983) 109, p77-83.

  13. Drolshagen C and Schaffer D. Use of absorbent antimicrobial and viscous hydrogel to manage ulcers secondary to peripheral vascular disease. Poster presented at the (1999) Symposium on Advanced Wound Care, Anahiem.

  14. Salman H and Leakey A. A report to Smith & Nephew Medical Ltd. The (in vitro) activity of silver Sulphadiazine and cadexomer iodine against recent clinical isolates of methicillin-resistant Staphylococcus aureus, methicillin-resistant coagulase-negative staphylococci and Pseudomonas aeruginosa. Report number 194-03-01 (March 2001).

  15. Mertz PM et al., Can Antimicrobials be effective without impairing wound healing? The evaluation of a cadexomer iodine ointment. Wounds (1994), 6(6), p184-193.

  16. Flayer C and Wilkinson JD. Treatment of venous leg ulcers with cadexomer iodine with particular reference to iodine sensitivity. Acta Chir Scand (1998) Suppl 544, p60-61.

How to Use

Cleanse the wound as per your facility’s protocol.

IODOSORB Ointment

IODOSORB Ointment Changing Step 2-4

Step 1
Spread IODOSORB Ointment in 3mm thick to cover dressing or directly to wound. After application, the remaining contents of the tube should be discarded due to loss of sterility.

Step 2
Position the prepared cover dressing onto the wound.

Step 3
When managing venous stasis ulcers, compression bandages should be used in addition to IODOSORB Ointment.

Step 4
Apply the cover dressing. The cover dressing chosen should be one that maintains a moist wound environment.

 

Changing IODOSORB Ointment
Each time the dressing is changed, the remaining IODOSORB Ointment should be gently washed from the wound or ulcer surface with a suitable cleansing solution (sterile water or saline) or with a sterile, wet swab.

How to use IODOSORB Ointment Step 1-3

Step 1
IODOSORB Ointment should be changed when saturated with wound fluid, indicated by a loss of color, usually 2-3 times a week or daily if wound is discharging heavily.

 Step 2
Gently and thoroughly remove any IODOSORB Ointment at each dressing change. 

Step 3
Gently blot any excess fluid, leaving the wound surface slightly moist, before re-applying IODOSORB Ointment. The number of applications should be reduced as the exudate diminishes.

Step 4
Apply the cover dressing over the wound. The cover dressing chosen should be one that maintains a moist wound environment.

 

IODOSORB Paste

Cleanse the wound as per your facility’s protocol.

IODOSORB Paste

Step 1
Choose a suitable size of dressing for the wound: 
5 g for wounds up to 6 cm x 4cm
10 g for wounds up to 8 cm x 6 cm
17 g for wounds up to 8 cm x 10 cm 

Step 2
Remove the carrier gauze on one or both sides of the IODOSORB Paste. 

Step 3
Apply IODOSORB Paste to wound surface. IODOSORB Paste can be molded or cut to fit wound. Any remaining product should be discarded due to loss of sterility. 

Step 4
Apply the cover dressing. The cover dressing chosen should be one that maintains a moist wound environment.

 

Changing IODOSORB Paste

Step 1
IODOSORB Paste should be changed when saturated with wound fluid, and all iodine has been released.  This is indicated by loss of color, usually 2-3 times a week or daily if wound is discharging heavily.

Step 2
If necessary, soak the dressing for a few minutes, and then remove. 

Step 3
Gently remove the IODOSORB Paste using a stream of water or saline. 

Step 4
Gently blot any excess fluid, leaving the wound surface slightly moist, before re-applying IODOSORB Paste. 

Step 5
Apply the cover dressing. The cover dressing chosen should be one that maintains a moist wound environment.

FAQ

Frequently asked questions about IODOSORB

How do I remove IODOSORB from the ulcer?

Remove the secondary dressing. If it is sticking to the IODOSORB, soak with sterile saline or water. To remove IODOSORB from the wound, simply flush it away with sterile saline or water. If there are any small remnants of IODOSORB left in the wound, don't worry they will be naturally degraded without causing any delay to healing or systemic reaction. 

 

How can I tell when the IODOSORB needs changing?

IODOSORB will change from a dark brown to off white which indicates that all the iodine has been released. This loss of color indicates that it is time to change the IODOSORB ointment or paste. The number of dressing changes therefore depends on the levels of infection and exudate present in the wound, but the product should normally be changed 2-3 times per week. 

Is there any risk of iodine absorption causing any problems for the patient?

Generally if you use IODOSORB within the guidelines of the prescribing information (up to a maximum of 150 g a week), it is unlikely that there will be any significant iodine absorption and therefore any systemic side effects. However, IODOSORB should not be used in patients with severely impaired renal function or a past history of any thyroid disorder as they are more susceptible to alterations in thyroid metabolism with chronic IODOSORB therapy. It has been observed occasionally that an adherent crust can form when IODOSORB is not changed with sufficient frequency. 

 

Can I use a secondary dressing to secure IODOSORB to the wound?

Yes, you can use any semi-permeable secondary dressing, or secure IODOSORB with bandages over a non-adherent piece of padding or gauze. 

 

Does IODOSORB cause patient pain in what often is already a painful ulcer?

IODOSORB desloughs by absorbing and drawing away slough and exudate from the wound surface. This is not harmful but indicates that the product is working. Sometimes patients feel a warm or smarting sensation and this may be due to the drawing effect of the slough and exudate.

Will IODOSORB relieve ulcer pain?

Yes, it has been shown to. Often IODOSORB will relieve pain whilst in the process of desloughing the wound and killing bacteria. In clinical trials, pain reduction has been a well observed benefit for patients. 

What organisms is IODOSORB effective against?

Because IODOSORB contains elemental iodine, it is effective against a wide range of pathogenic bacteria, fungi, yeasts which can delay wound healing. There have been no reports of acquired resistance with iodine. 

For how long can I use IODOSORB on a slow healing ulcer?

IODOSORB can be used for up to 3 months. At this stage if the ulcer still needs treatment, a non-iodine containing product must be used for a minimum of one week before resuming treatment with IODOSORB. 

What is the largest amount of IODOSORB I can use in a week?

150 g of IODOSORB can be applied per patient per week. A single application should not exceed 50 g. 

Can IODOSORB be used in patients who are sensitive to iodine?

No. 

Will IODOSORB delay wound healing as it contains an antiseptic?

There is a body of evidence showing that some antiseptic containing products delay wound healing. IODOSORB has in fact been shown to accelerate healing in some studies1.

References

1. Drosou A, Falabella A, Kirsner RS. Antiseptics on Wounds: An Area of Controversy. Wounds 2003 15(5): 149-66

Significant evidence at the highest level

Consensus guidelines for the identification and treatment of biofilms in chronic non-healing wounds

Click here to read the consensus summary

Click here to read the consensus on PubMed

Conclusions from the Cochrane Review of antiseptics and antibiotics
for venous leg ulcers

Click here to read the summary

Click here to read the review on the Cochrane website