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CADESORB

Proteasemodulerende salve

CADESORB

Om CADESORB

Genopret den naturlige balance med CADESORB

CADESORB er en hvid, stivelsesbaseret, steril salve, som regulerer pH-niveauet i lokale sår, og derved modulerer proteaseaktiviteten. CADESORB har specifikt til formål at regulere pH-niveauet i det lokale miljø.

CADESORB vil ved at regulere pH-niveauet og modulere proteaseaktiviteten, og samtidig tage hånd om afstødt væv og ekssudat, være med til at oprette den naturlige balance i kroniske sår og stimulere heling.

  • Reduceret proteaseaktivitet kan hjælpe til at forebygge nedbrydning af den ekstracellulære matrix
  • CADESORB fremmer helingen i kroniske sår ved at regulere sårmiljøet

CADESORB Ointment

CADESORBs virkningsmekanisme
Hvad er CADESORB?

Undersøgelser har vist, at kroniske sår almindeligvis har en pH-værdi på omkring 7 8. Der foreligger evidens, som indikerer, at et lettere surt miljø kan fremme helingen af åbne sår.  Ex vivo-undersøgelser har vist, at CADESORB-behandling af sårvæske sænker pH-værdien til omkring 5, hvilket muliggør, at niveauet af proteaseaktivitet vender tilbage til niveauet for et helende sår.

Udover fordelene ved pH-regulering og proteasemodulering fremmer CADESORB fjernelsen af afstødt væv og absorberer samtidig sårekssudat.

  • Fjernelse af dødt væv
    CADESORB er i stand til at fjerne dødt væv og affaldsstoffer fra såret.
  • Absorptionsevne
    CADESORB vil regulere sårekssudatet i op til 3 dage afhængig af niveauet af drænage.

 

Pakningsstørrelser

CADESORB fås i tuber med 10 g og 20 g

 

Referencer

1 Yager, D.R.,Nwomeh, B. C. The proteolytic environment of chronic wounds. Wound Rep. Reg. 1999 ;7; 433-441

2 Bullen,E.C., Longmaker M.T., Updike, D.L. et al. Tissue inhibitor of metalloprotinases-I is decreased and activated gelatinases are increased in chronic wounds. J invest Dermatology 1995; 104;236-240.

3 Yager D.R., Zhang,L.Y., Liang, H.X., et al. Wound fluids from Human pressure ulcers contain elevated matrix metalloproteinase levels and activity compared to surgical wound fluids. J Invest Dermatology 1996;107; 743-748.

4 Wysocki, A.,Staiano-Coico, L., Grinnell, F. Wound fluid from chronic leg ulcers contains elevated levels of metalloprotinases MMP-2 and MMP-9. J Invest Dermatology 1993;101;64 – 68.

5 Tarnuzzer, R. W., Schultz G.S.,Biochemical analysis of acute and chronic wound environments. Wound Rep. Reg. 1996;4;321 – 325.

6 Proteases and pH on chronic wounds by Greener Hughes, Bannister and Douglass, Journal of wound care 14:2:59- 61

7 Asmussen PD, Söllner B. Principles of Wound Healing. Germany (Stuttgart): Druckerei Kohlhammer.

9 Trengove NJ, Stacey MC, Macauley S, Bennett N, Gibson J, Burslem F, Murphy G, Schultz G. Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors. Wound Rep Reg. 1999;7:442-52.

10 Herrick S, Ashcroft G, Ireland G. et al. Up-Regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers are associated with matrix degradation. Laboratory Investigation 1997, 77; 281-8.

11 Dissemond J, Witthoff M, Brauns TC. et al. pH values in chronic wounds. Evaluation during modern wound therapy (in German). Hautarzt 2003;54: 959-65.

12 Kaufman T, Berger J. Topical pH and burn wound healing: a review. In Ryan TJ (ed) Beyond Occlusion: Wound Care Proceedings. London, RSM Services Ltd. 1988, 55-59.

13 Leveen HH, Falk G, Borek B et al. Chemical acidification of wounds: an adjuvant to healing and the unfavorable action of alkalinity and ammonia. Ann Surg 1973. 178.745-53.

14 Wilson IAI, Henry M, Quill RD, Byrne PJ. The pH of varicose ulcer surfaces and its relationship to healing. Vasa 1979:8 339-342.

15 Dissemond J, Witthoff M, Grabbe S. Investigations on pH values in milieus of chronic wounds during modern wound therapy. Presented at World Congress, Paris 2004.

16 Evaluation of model matrix damaging potential of fresh chronic wound fluids and matrix protecting ability of CADESORB™, S&N Data on File Report 0410020.

17 CADESORB Mode of Action. S&N Data on File Report 0412025.

18 Evaluation of model matrix damaging potential of fresh chronic wound fluids and matrix protecting ability of CADESORB and Promogran, S&N Data on File Report 0410021.

19 In-vitro evaluation of the effect of CADESORB and Promogran on the proliferation of three different microorganisms in the presence of serum. S&N Data on File Report 0410019.

20 Moberg S, Hoffman L, Grennert ML, Holst A. A randomized trial of cadexomer iodine in decubitus ulcers. J Am Geriatr Soc, 1983; 31(8): 462-5.

21 Ormiston MC, Seymour MT, Venn GE, Cohen RI, Fox JA. Controlled trial of IODOSORB in chronic venous ulcers. Br Med J (Clin res Ed), 1985;291 (6491): 308-10.

22 Wound Management and dressings. The pharmaceutical press 1990. Steve Thomas

23 A Koerber, J Freise, S Grabbe, J Dissemond. The lowering of pH values in chronic wounds by the application of CADESORB. Poster presentation EWMA Stuttgart 2005.

24 G Robers, A Chumley, R Mani The Wound Milieu in Venous Ulcers – Further Observations. Oral presentation EWMA Stuttgart 2005

25 Matrix protection ability of Cadesorb vs Promogran Smith and Nephew. Data on file 0510001

26 An in vitro assessment of the impact of CADESORB ointment on the antimicrobial properties of various topical antimicrobial agents and dressings (ACTOCOAT◊ Burn, IODOFLEX◊ dressing, Gentalyn Cream, Gentalyn Ointment and FLAMAZINE◊ Cream). Smith and Nephew. Data on file 0505002

27 Anderson L, Iodphore Gel – in-vitro enzymatic hydrolysis of Iodphore Gel and other modified starch gels by endogenous amylase. Micro Chem Development Laboratory AB. 20/06/1979.

Ofte stillede spørgsmål

Hvor ofte skal jeg skifte CADESORB?

CADESORB skal skiftes hver 3. dag afhængig af mængden af ekssudat. CADESORB nedbrydes naturligt af kroppen med tiden, så overskydende salve vil ikke forårsage problemer.

Hvordan ved jeg, hvornår CADESORB skal skiftes?

Den tid, det tager CADESORB at blive gennemvædet og nå sin absorptionskapacitet, vil afhænge af mængden af sårekssudat. Når dette sker, vil det overskydende ekssudat være synligt som gennemsivning af den sekundære bandage.
Antal bandageskift afhænger derfor af sårets ekssudatniveau.

Kan jeg bruge CADESORB under kompressionsbehandling?

 Ja, CADESORB kan bruges under kompressionsbehandling.

Kan jeg bruge CADESORB på et inficeret sår?

CADESORB er ikke indiceret til inficerede sår. Den kan bruges, så snart infektionen er væk.

 

Hvordan fjerner jeg CADESORB fra såret?

Fjern den sekundære bandage. Hvis den sidder fast i CADESORB eller såret, skal såret vædes med sterilt fysiologisk saltvand eller vand. Du fjerner ganske enkelt CADESORB fra såret ved at skylle det væk med sterilt fysiologisk saltvand eller vand.
Hvis der stadig sidder en smule CADESORB i såret, nedbrydes salven naturligt, uden at dette sinker helingen eller forårsager en systemisk reaktion.

Kan jeg bruge en sekundær bandage til at bevare CADESORB på såret?

Ja, du kan bruge en egnet sekundær bandage. OPSITE◊ Post-Op kan være egnet til sår med lavt ekssudatniveau, hvorimod ALLEVYN◊ vil regulere større mængder ekssudat, når dette er nødvendigt.
CADESORB kan også bruges under kompressionsbandager.

Hvor længe må jeg bruge CADESORB?

CADESORB kan bruges, indtil såret er helet, hvis der er tegn på sårheling, og der er ekssudat.

Kan jeg komme til at bruge for meget CADESORB på såret? Vil det sænke pH-niveauet til en surhedsgrad, som kunne være skadelig?

Det er højst usandsynligt, at der kan bruges for meget CADESORB på såret.  pKa-værdien for CADESORB-syre (4,75) dikterer, at den lokale pH-værdi ikke vil falde med mere end 1 pH-enhed på hver side af værdien.
Det anbefales dog, at der bruges nok til at dække såret (1 2 mm), uden at efterlade store mængder rundt om såret.

Cadesorb Ointment

Referencer

1 Yager, D.R.,Nwomeh, B. C. The proteolytic environment of chronic wounds. Wound Rep. Reg. 1999 ;7; 433-441

2 Bullen,E.C., Longmaker M.T., Updike, D.L. et al. Tissue inhibitor of metalloprotinases-I is decreased and activated gelatinases are increased in chronic wounds. J invest Dermatology 1995; 104;236-240.

3 Yager D.R., Zhang,L.Y., Liang, H.X., et al. Wound fluids from Human pressure ulcers contain elevated matrix metalloproteinase levels and activity compared to surgical wound fluids. J Invest Dermatology 1996;107; 743-748.

4 Wysocki, A.,Staiano-Coico, L., Grinnell, F. Wound fluid from chronic leg ulcers contains elevated levels of metalloprotinases MMP-2 and MMP-9. J Invest Dermatology 1993;101;64 – 68.

5 Tarnuzzer, R. W., Schultz G.S.,Biochemical analysis of acute and chronic wound environments. Wound Rep. Reg. 1996;4;321 – 325.

6 Proteases and pH on chronic wounds by Greener Hughes, Bannister and Douglass, Journal of wound care 14:2:59- 61

7 Asmussen PD, Söllner B. Principles of Wound Healing. Germany (Stuttgart): Druckerei Kohlhammer.

9 Trengove NJ, Stacey MC, Macauley S, Bennett N, Gibson J, Burslem F, Murphy G, Schultz G. Analysis of the acute and chronic wound environments: the role of proteases and their inhibitors. Wound Rep Reg. 1999;7:442-52.

10 Herrick S, Ashcroft G, Ireland G. et al. Up-Regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers are associated with matrix degradation. Laboratory Investigation 1997, 77; 281-8.

11 Dissemond J, Witthoff M, Brauns TC. et al. pH values in chronic wounds. Evaluation during modern wound therapy (in German). Hautarzt 2003;54: 959-65.

12 Kaufman T, Berger J. Topical pH and burn wound healing: a review. In Ryan TJ (ed) Beyond Occlusion: Wound Care Proceedings. London, RSM Services Ltd. 1988, 55-59.

13 Leveen HH, Falk G, Borek B et al. Chemical acidification of wounds: an adjuvant to healing and the unfavorable action of alkalinity and ammonia. Ann Surg 1973. 178.745-53.

14 Wilson IAI, Henry M, Quill RD, Byrne PJ. The pH of varicose ulcer surfaces and its relationship to healing. Vasa 1979:8 339-342.

15 Dissemond J, Witthoff M, Grabbe S. Investigations on pH values in milieus of chronic wounds during modern wound therapy. Presented at World Congress, Paris 2004.

16 Evaluation of model matrix damaging potential of fresh chronic wound fluids and matrix protecting ability of CADESORB™, S&N Data on File Report 0410020.

17 CADESORB Mode of Action. S&N Data on File Report 0412025.

18 Evaluation of model matrix damaging potential of fresh chronic wound fluids and matrix protecting ability of CADESORB and Promogran, S&N Data on File Report 0410021.

19 In-vitro evaluation of the effect of CADESORB and Promogran on the proliferation of three different microorganisms in the presence of serum. S&N Data on File Report 0410019.

20 Moberg S, Hoffman L, Grennert ML, Holst A. A randomized trial of cadexomer iodine in decubitus ulcers. J Am Geriatr Soc, 1983; 31(8): 462-5.

21 Ormiston MC, Seymour MT, Venn GE, Cohen RI, Fox JA. Controlled trial of IODOSORB in chronic venous ulcers. Br Med J (Clin res Ed), 1985;291 (6491): 308-10.

22 Wound Management and dressings. The pharmaceutical press 1990. Steve Thomas

23 A Koerber, J Freise, S Grabbe, J Dissemond. The lowering of pH values in chronic wounds by the application of CADESORB. Poster presentation EWMA Stuttgart 2005.

24 G Robers, A Chumley, R Mani The Wound Milieu in Venous Ulcers – Further Observations. Oral presentation EWMA Stuttgart 2005

25 Matrix protection ability of Cadesorb vs Promogran Smith and Nephew. Data on file 0510001

26 An in vitro assessment of the impact of CADESORB ointment on the antimicrobial properties of various topical antimicrobial agents and dressings (ACTOCOAT◊ Burn, IODOFLEX◊ dressing, Gentalyn Cream, Gentalyn Ointment and FLAMAZINE◊ Cream). Smith and Nephew. Data on file 0505002

27 Anderson L, Iodphore Gel – in-vitro enzymatic hydrolysis of Iodphore Gel and other modified starch gels by endogenous amylase. Micro Chem Development Laboratory AB. 20/06/1979.

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