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Wound Care

wound-care
Per a prescription order, a formulation can be compounded to contain the proper combination of active ingredients, in the most appropriate base, to treat a specific type of wound. We customize medications to meet each individual’s specific needs.

For example, the choice of cream, ointment, or gel can be clinically significant. Each time a wound needs to be cleaned, there is the potential for disruption of new tissue growth. Gels, which are more water soluble than creams or ointments, may be preferable for wound use because a gel can be rinsed from the wound by irrigation. Ointments may contain polyethylene glycol (PEG), which can be absorbed from open wounds and damaged skin. If the wound is quite large and too much PEG is absorbed, it can lead to renal toxicity.

Another useful dosage form is the polyox bandage – which can be puffed onto a wound and will adhere even if exudate is present. A polyox bandage can be compounded to contain the active ingredient(s) of your choice.


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Odor Control

Odor from malignant cutaneous wounds, ulcerated tumors, some pressure ulcers, and fungating tumors can cause great distress and embarrassment for patients. Topical metronidazole is one medication that has been used to eliminate this odor, greatly improving the patient’s quality of life. Exudate and associated cellulitis may also decrease significantly with appropriate topical therapy.

Ostomy Wound Manage 1997 Jan-Feb;43(1):56-60, 62, 64-6

Malignant Cutaneous Wounds: a Management Protocol

Haisfield-Wolfe ME, Rund C

Johns Hopkins Oncology Center, Baltimore, MD, USA.

Malignant cutaneous wounds are emotionally traumatic and difficult to manage lesions which occur secondary to infiltration of cancer into the skin. They occur in patients with end-stage disease and are highly exudative, malodorous, and bleed easily. Quality of life is the goal for treatment, which includes radiation, chemotherapy, surgery, and local wound care. Odor is addressed with varying levels of success through wound cleansing, external deodorizers, charcoal-impregnated dressings, topical antimicrobial therapy, and metronidazole. Exudate is managed with highly absorbent dressing materials, topical steroids or hyoscine (a drying agent). Light bleeding is controlled with local pressure and hemostatic dressings; heavier bleeding may require ligation or cauterization. Cosmetic appearance and other psychosocial issues must be assessed on an ongoing basis. Creative dressing techniques can help restore the look of symmetry to the patient’s body. Effective wound management, debridement, and antimicrobial theray can reduce the risk of infection. Wound cleansing, through irrigation or flushing, should not cause pain, further trauma or bleeding. Dressings should maintain a moist wound environment and not traumatize the wound upon removal. A protocol is included which can be individualized to the needs of each patient and addresses assessment, interventions, patient teaching, documentation, and expected outcomes.

PMID: 9087066


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Skin Irritation

Numerous topical preparations containing cholestyramine or sucralfate (creams, adhesive pastes, enemas, suppositories) have been used for their protectant properties or for treatment of a variety of dermatologic and mucosal problems, including oral and esophageal ulcers, peristomal and perineal excoriation, decubitus ulcers, and radiation-induced rectal and vaginal ulcerations, and second and third degree burns.

Ann Pharmacother 1996 Sep;30(9):954-6

Cholestyramine ointment to treat buttocks rash and anal excoriation in an infant.

White CM, Gailey RA, Lippe S.
Albany College of Pharmacy, NY 12208, USA.

Click here to access the PubMed abstract of this article.

Dis Colon Rectum 1987 Feb;30(2):106-7

Cholestyramine ointment in the treatment of perianal skin irritation following ileoanal anastomosis.

Moller P, Lohmann M, Brynitz S.

Click here to access the PubMed abstract of this article.

Clin Exp Dermatol. 2000 Nov;25(8):584-8

Topical sucralfate in the management of peristomal skin disease: an open study.

Lyon CC, Stapleton M, Smith AJ, Griffiths CE, Beck MH.
Dermatology Centre, University of Manchester, and the Pharmacy and the Department of Stoma-Care, Hope Hospital, Salford, UK.

Click here to access the PubMed abstract of this article.

Burns. 2001 Aug;27(5):465-9

Topical use of sucralfate cream in second and third degree burns.

Banati A, Chowdhury SR, Mazumder S.
Department of Plastic Surgery and Burns Research Unit. Institute of Post Graduate Medical Education and Research, 220, Acharya Jagadish Chandra Bose Road, -700 020, Calcutta, India.

Click here to access the PubMed abstract of this article.


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Custom Prescription Dosage Forms

The Health Dimensions, Inc. pharmacists are problem solvers in the community, working with patients and physicians to gain positive outcomes. With our expertise in custom preparing medications, Health Dimensions, Inc. can compound any of the following dosage forms:

  • Capsules: immediate release or slow release
  • Drops: ear and nasal
  • Injectables: intravenous, subcutaneous, intra muscular, intra spinal
  • Nutritional and herbal therapies
  • Pellets
  • Sprays: nasal, inhalers, topical ear and oral
  • Suppositories: rectal and vaginal
  • Transdermals: cream, gel ointment, powder

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