BNF for Children 2011-2012

594 13.11.1 Alcohols and saline BNFC 2011–2012Histoacryl c (Braun)Tissue adhesive, sterile, enbucrilate, net price 5 200-mg unit (blue) = £32.00, 10 200-mg unit (blue)= £67.20, 5 500-mg unit (clear or blue) = £34.65, 10 500-mg unit (blue) = £69.30LiquiBand c (MedLogic)Tissue adhesive, sterile, enbucrilate, net price 0.5-gamp = £5.5013.11 Skin cleansers,antiseptics, andpreparations forpromotion of woundhealing13.11.1 Alcohols and salineALCOHOLCautions flammable; avoid broken skin; patients havesuffered severe burns when diathermy has been precededby application of alcoholic skin disinfectantsContra-indications neonates, see section 13.1Indication and doseSkin preparation before injectionApply to skin as necessaryIndustrial Methylated Spirit, BPSolution, 19 volumes of ethanol and 1 volumeapproved wood naphtha, net price ‘66 OP’ (containing95% by volume alcohol) 100 mL = 39p; ‘74 OP’(containing 99% by volume alcohol) 100 mL = 39p.Label: 15Surgical Spirit, BPSpirit, methyl salicylate 0.5 mL, diethyl phthalate 2%,castor oil 2.5%, in industrial methylated spirit, netprice 100 mL = 20p. Label: 1513 Skin13.11.1 Alcohols and saline13.11.2 Chlorhexidine salts13.11.3 Cationic surfactants and soaps13.11.4 Iodine13.11.5 Phenolics13.11.6 Oxidisers and dyes13.11.7 Preparations for promotion of woundhealingSoap or detergent is used with water to cleanse intactskin but they can irritate infantile skin; emollient preparationssuch as aqueous cream or emulsifying ointment(section 13.2.1) that do not irritate the skin arebest used in place of soap or detergent for cleansing dryor irritated skin.An antiseptic is used for skin that is infected or that issusceptible to recurrent infection. Detergent preparationscontaining chlorhexidine or povidone–iodine,which should be thoroughly rinsed off, are used. Emollientsmay also contain antiseptics (section 13.2.1).Antiseptics such as chlorhexidine or povidone–iodineare used on intact skin before surgical procedures; theirantiseptic effect is enhanced by an alcoholic solvent.Antiseptic solutions containing cetrimide can be used ifa detergent effect is also required.Preparations containing alcohol and regular use ofpovidone iodine should be avoided on neonatal skin(see section 13.1).Hydrogen peroxide, an oxidising agent, is available as acream and can be used for superficial bacterial skininfections.For irrigating ulcers or wounds, lukewarm sterile sodiumchloride 0.9% solution is used but tap water isoften appropriate.Potassium permanganate solution 1 in 10 000, a mildantiseptic with astringent properties, can be used as asoak for exudative eczematous areas (section 13.5.1);treatment should be stopped when the skin becomesdry. Potassium permanganate can stain skin and nailsespecially with prolonged use.SODIUM CHLORIDEIndication and doseSee notes aboveNebuliser diluent section 3.1.5Sodium depletion section 9.2.1.2Electrolyte imbalance section 9.2.2.1Eye section 11.8.1Oral hygiene section 12.3.4Sodium Chloride (Non-proprietary)Solution (sterile), sodium chloride 0.9%, net price 25 20-mL unit = £5.50, 200–mL can = £2.65, 1 litre =97pFlowfusor c (Fresenius Kabi)Solution (sterile), sodium chloride 0.9%, net price120-mL Bellows Pack = £1.53Irriclens c (ConvaTec)Solution in aerosol can (sterile), sodium chloride0.9%, net price 240-mL can = £3.30Irripod c (C D Medical)Solution (sterile), sodium chloride 0.9%, net price 25 20-mL sachet = £5.50Miniversol c (Aguettant)Solution (sterile), sodium chloride 0.9%, net price 30 45-mL unit = £13.20; 30 100-mL unit = £19.50Normasol c (Mölnlycke)Solution (sterile), sodium chloride 0.9%, net price 25 25-mL sachet = £6.14; 10 100-mL sachet = £7.47Stericlens c (C D Medical)Solution in aerosol can (sterile), sodium chloride0.9%, net price 100-mL can = £1.94, 240-mL can =£2.95