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Iodosorb* Product Range

Product Properties

Iodosorb* Product Range

 
 
 

This information is intended for Healthcare Professionals only.

 

 

 
 

 

Iodosorb* is a range of Cadexomer Iodine based products, available in two presentations.

 

 

Iodosorb removes barriers to healing by its dual action antimicrobial and desloughing properties. The broad spectrum antimicrobial action is provided by the sustained release of iodine and the desloughing action is provided by the unique cadexomer matrix.

 

By effectively removing the barriers of bacteria, slough and debris and excess exudate, Iodosorb has been shown to accelerate wound healing in leg ulcers and is effective for the treatment of infection in chronic exuding wounds.

 

Claims

  • Provides sustained antimicrobial activity
  • Effectively reduces the bacterial load, including MRSA
  • Helps to prevent new pathogen invasion
  • Removes loose slough and debris to clean the wound bed
  • Manages excess exudate in highly exuding wounds
  • Creates a moist wound environment
  • Accelerates healing in leg ulcers

 

References

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Benefits

  • Clinically proven to treat infection
  • Effective deslougher
  • High absorbency
  • Wide range of high level clinical support
  • Versatile range
  • Changes colour as iodine is released
  • Encourages wound healing
  • Helps to eliminate odour

 

 

 

Features

 

  • Changes colour: to indicate when dressing change is needed
  • Non - adherent: can be removed with saline to help reduce trauma to the patient and increase patient quality of life
  • Biodegradable
  • Range of sizes: Aids dressing selection
    Helps reduce wastage

Wound

 

Wound

 

 

 

Presentations

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Product Properties

 

Iodosorb is a dual action wound management product that has been shown to accelerate healing in leg ulcers. It offers the benefits of a broad spectrum slow release antimicrobial agent in combination with desloughing and fluid handling properties. Iodosorb is effective at treating infection and preparing the wound bed to heal in highly exuding chronic wounds.

 

 

 

 

 

 

Iodosorb Family

Product in use

This information is intended for Healthcare Professionals only.

"The effect of Cadexomer Iodine on pain and its ease of application and removal gave high acceptance by patients and nurses" 17

Considering an appropriate topical antimicrobial treatment

The importance of wound infections, in both economic and human terms, should not be underestimated. Practitioners need to know how to recognise and manage the signs and consequences of clinically infected wounds. The key principles for the management of a patient with a wound infection can be summarised as follows 15:

  • Treat the patient holistically
  • Recognise the signs of inflammation/increased bacterial burden/clinical infection
  • Be able to take 'reliable' wound swabs
  • Be able to interpret culture reports
  • Treat the infection - causative organism(s)
  • Consider antibiotic sensitivities
  • Consider which wound management products are suitable and appropriate*
  • Minimise the risk of cross - infection
  • Reduce the risk of any complications
  • Educate the patient and his/her family and carers.

*Topical antimicrobials are used to reduce bio-burden; therefore, the choice has to be related to the identity of the causative organisms, assessed either through bacterial culture or clinical judgement. The choice of topical agent should also include an awareness of their potential to induce sensitisation.

Application

Iodosorb Dressing
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Photo of Iodosorb Dressing on an arm

Iodosorb Ointment

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Photo of iodosorb dressing on arm after use

Contraindications

  • Iodine sensitivity
  • Hashimoto's thyroiditis
  • Non-toxic nodular goitre
  • Children
  • Pregnant or lactating women

Warnings and Precautions

  • Iodine may be absorbed systemically
  • Avoid in patients with thyroid disorders or severely impaired renal function
  • In endemic goitre, iodine can cause hyperthyroidism
  • Potential interaction with lithium, therefore co-administration is not recommended
  • Should not be used with mercurial antiseptics
  • Can affect tests of thyroid function
  • Dressing may dry out if not changed often enough

References

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Iodosorb Family

Technology

This information is intended for Healthcare Professionals only.

Cadexomer Iodine: Intelligent Interactive Iodine

Cadexomer Iodine is a uniquely formulated starch matrix formed into spherical, highly absorbent microbeads containing 0.9% elemental iodine.

The Cadexomer is a 3D cross - linked polysaccharide starch matrix. The 0.9% iodine is physically bound to the cadexomer matrix and is only released when it is required.

Cadexomer Iodine: The Mode of Action

Wound fluid and exudate are absorbed into the cadexomer beads of the Cadexomer Iodine, allowing the iodine to be released slowly. Please refer to the animation below.

When Cadexomer Iodine is applied to the wound surface, exudate, pus and debris are absorbed into the cadexomer beads. The beads will swell resulting in the formation of a demonstrable gel.

The presence of exudate and the consequent swelling of the beads results in the cross - linked bonds of the cadexomer matrix breaking and the iodine being released into the surrounding wound environment. When the iodine is released, the amount of iodine released will be to a level such that the concentration of iodine in the dressing and the wound environment reach an equilibrium. The equilibrium will remain and no further iodine will be released until the balance is disturbed.

Once the iodine in the surrounding wound environment has been depleted, more will be released from the product until the equilibrium is reached again and will remain until disturbed. This process will continue until all the 0.9% iodine within the product has been exhausted. The conversion of iodine is also associated with a colour change from orangey brown to white. Therefore once all the iodine has been converted and utilised, the Iodosorb will appear white in colour. At this point it is time to make a dressing change.

References

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Cadexomer iodine

Clinical Background

This information is intended for Healthcare Professionals only.

Expert Statement

Vincent Falanga, MD
Professor of Dermatology and Biochemistry

Vincent Falanga, MD

"The development of slow-release antiseptic agents, such as those based on iodine, has rendered antiseptics safe, effective, and reliable in the management of difficult wounds. In my own practice, I have found these therapeutic agents particularly useful in the bacterial "de-colonization" of chronic wounds, an important step in the overall approach to wound bed preparation. As a result, patient management is greatly facilitated, whether one is simply applying standard treatments or using more advanced therapies. The bacterial burden decreases, as does wound exudate. Quite frankly, I don't know what I would do without the use of slow-release antiseptics, particularly in the outpatient setting. I do know that some of my clinician colleagues are still fearful of the word "antiseptics". This fear is rooted in old literature on the use of "straight" antiseptics, with no mechanisms for slow and smart delivery. However, in the field of medicine and in caring for patients, one needs to adapt while remaining critical, and most of all be vigilant about new opportunities that can help our patients.

Clinical Evidence

Detailed below is a list of the numerous papers related to Iodosorb*.

Click on this link to read a Review of the Clinical Evidence for Iodosorb and Iodoflex*

Please select an area to view the associated clinical paper abstracts:

Case studies

Dr Marazzi treats 3 patients with Diabetic Foot Ulcers:

Case study 1 Female, 39 years old, with diabetic ulcer in her right foot for 2 years.
Case study 1
Case study 2 Male, 65 years old, with diabetic ulcers of the right foot.
Case study 2
Case study 3 Male, 66 years old, with diabetic ulcer (right foot) for 2 months.
Case study 3

Dr Gordon Dow presents on the use of Iodosorb in various aetiologies:

Click here to view a summary of the Dow slides above

References

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Glossary

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Prescribing Information

Cadexomer iodine should not be used on patients with known or suspected sensitivity to iodine and is contraindicated in Hashimoto's Thyroiditis. In patients with a prior history of hyperthyroidism, it is not recommended to use iodine-containing products. Cadexomer iodine should not be used in the case of non-toxic nodular goitre.

Warning

Iodine is absorbed systemically. Patients with a past history of any thyroid disorder are more susceptible to alteration in thyroid metabolism with chronic Cadexomer iodine therapy. There is a potential interaction of iodine with lithium and therefore co-administration is not recommended.

Dosage

Single does should not exceed 50g.

Weekly dose should not exceed 150g.

A single course of treatment should not exceed 3 months.

Pregnancy

Iodine can cross the placenta barrier and is secreted into the milk. Do not use Cadexomer iodine on pregnant or lactating women.

Paediatric Patients

Iodosorb should not be used in children under 12 years of age.

FAQs

This information is intended for Healthcare Professionals only.

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 indicates that it is time to change the Iodosorb. The number of dressing changes therefore depend on the levels of infection and exudate present in the wound.

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 150g 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. In endemic goitre there have been isolated reports of hyperthyroidism associated with exogenous iodine. 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. Iodine is also highly effective against Methicillin Resistant Staphylococcus Aureus (MRSA). 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?

150g of Iodosorb can be applied per patient per week. A single application should not exceed 50g. If more is needed, refer to the warnings on the relevant data sheet and prescribing information.

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

No, this is not recommended.

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 been also tested in-vivo and has been shown not to reduce fibroblast or macrophage activity 18. Iodosorb has in fact been shown to accelerate healing in some studies 2.

References

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Iodosorb family