Diphoterine® solutions

This severe water uptake is confirmed by the next figure (Fig. 6.3) showing the hydration of the cornea after bum that is kept untreated for up to 7 days or respectively treated by three times daily rinsing of the eye with phosphate buffer (Isogutt ), saline solntion, or Diphoterine solution for 16 days. 

Flush eyes with copious amounts of tepid 0.9% saline or water for at least 15 min. Diphoterine solution can be used for decontamination of both eyes and skin after exposure to lacrimators (Viala et al., 2005). Ocular signs resolve... 

Figure 4.7 shows the experimental device. One milliliter of titaninm tetrachloride is used for this experience. What does happen during the addition of an increasing volume of water and, in comparison, with an increasing volume of DIPHOTERINE solution The reaction instantaneously generates a release of energy and an increase of temperature. Very quickly, when adding 5 mL of water or DIPHOTERINE solution, this exothermic effect decreases, because of dilution, and the tanperature falls back to 20 °C. 

On this purely physical aspect, water and DIPHOTERINE solution have the same effect. DIPHOTERINE solution improves the washing effect of water by restoring the pH toward the physiologically acceptable zone while water maintains a corrosive pH (Fig. 4.8). For the latter sulfuric acid, the fundamental elanent of aggressiveness is the persistence of pH valnes out of the physiological range. 

Example of high concentrated 95 % sulfuric acid (H2SO4). In contact with water, the static solvation of 1 mL of add releases a very big quantity of heat. The temperature reaches nearly 80 °C (Fig. 4.10). The result is the same with addition of water or DIPHOTERINE solution. 

Evolution of the temperature during an external rinsing simulation of 1 mLof 95 % sulfuric acid (H2SO4) comparing DIPHOTERINE solution and tap water... 

High concentration of acetic acid, virtually excludes the presence of water. It is named glacial acetic acid. Experimental dilution with tap water at 20.3 °C, in comparison with DIPHOTERINE solution at 19.9 °C, shows the following curves (Fig. 4.12). 

With this acid, despite the water pumping, the dilution does practically not increase the temperature of the mixture, even in static. The results are similar with the use of DIPHOTERINE solution. A much lower exothermic effect, compared to the previous examples, is observed. 

Fig. 4.12 Glacial acetic acid dilution by tap water or DIPHOTERINE solution...

Static dilution of 1 mL of 99.7 % glacial acetic acid Comparison between water and Diphoterine solution... 

The following experience is a simple dosage of 1 mL of each chemical peeling agent by an increasing volume of water (pH=7) and DIPHOTERINE solution (Fig. 4.21). 

Fig. 4.21 Dosage of 70 % glycolic acid or 20 % trichloroacetic acid by water versus DIPHOTERINE solution...

DIPHOTERINE solution can control pH value toward a physiological acceptable value with less volume than water does. No heat release is observed. 

The rats were randomly divided into three different treatment groups of five animals each (plus one of burned but untreated controls), and then treated for 30 s with a continuous flow (50 mL/ min) of 0.9 % saline solution, calcium gluconate, or DIPHOTERINE solution. Blood samples were taken 6 h, 48 h, and 7 days after the chemical bums to evaluate ... 

In Ihe evaluation of the different healing times, the group of rats washed with DIPHOTERINE solution presented better and advanced healing of the bums area (4-5°) in comparison with saline solution (in which a 3 ° of wound healing was noted and initial re-epithelization), calcium gluconate (in which there was a 2-3° of wound healing with a delay of detersion) [15]. The evaluation scale adopted had 5° ... 

In the evaluation of the response in pain development, the results showed a decrease of the level of substance P in the group treated with DIPHOTERINE solution in comparison with all the other groups, above all after 6 and 48 h after the application of 52 % hydrochloric acid, and an increase in the plasma concentrations of P-endorphin (after 7 days) in the group washed with DIPHOTERINE solution in comparison with the other groups (Figs. 4.47 and 4.48). 

This aspect is interesting and should be stressed in further studies, as DIPHOTERINE solution reduces the oxidative stress involved. The differences in the levels of biological markers were most likely due to the improved washing properties of DIPHOTERINE solution which left less hydrochloric acid residue on the skin to cause injury. 

In the experimental conditions studied, in rats with 52 % hydrochloric acid bums, DIPHOTERINE solution washing was superior to either normal (0.9 %) saline or calcium gluconate solution to mitigate the chemical bums and provide less lesions in terms of wound healing and various biochemical markers. Further studies are warranted. 

Two studies done in China in a rabbit model with concentrated sodium hydroxide and concentrated sulfuric acid found that there were no significant skin temperature changes, and while DIPHOTERINE solution rapidly returned the skin pH to normal values, water rinsing did not do so [207, 208]. 

Amphoteric Agents Water-Based Solution Containing Amphoteric Agents Such as DIPHOTERINE Solution and HEXAFLUORINE Solution... 

Design of DIPHOTERINE solution was also to add new additional secondary properties, so as to go beyond the limits of water when possible ... 

Improve the mechanical effect of water by attracting the chemicals and stopping their penetration through the skin. DIPHOTERINE and HEXAFLUORINE solutions are to chemicals what soap is to grease. They improve the washing effect and leave a cleaner surface. DIPHOTERINE solution is not only water but, to continue this picture, it is water plus soap. ... 

An experiment was conducted by Battelle USA Comparison of the Mechanical Effect of DIPHOTERINE solution using pH Measmement in 2010. It compared the effect of Milli-Q water versus DIPHOTERINE ... 

During the first study, washing hydrochloric acid solution, DIPHOTERINE solution returned the pH of a 1 M hydrochloric acid (HCl) and sodium hydroxide (NaOH) solution to physiological acceptable values (5.5-9.0), while with addition of similar volume of water, the pH remained 2 (HCl) or 12 (NaOH), respectively [242]. DIPHOTERINE solntion has the ability to decontaminate more than 1,200 chemicals/chem-ical classes for an npdated Ust see http //www. prevor.com/EN/sante/RisqueChimique/produits testes/produitsTestesV2.php. 

With alkahne corrosive, TMAH (tetramethyl-ammonium hydroxide, in vitro it required 17 times more water than DIPHOTERINE solution to achieve pH normalization [243]. In an in vitro MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphen-yltetrazolium bromide) cell toxicity assay, 2/3 of cell remained viable after DIPHOTERINE solution washing compared with only 1/3 of cells which remained viable after water washing [243]. 

Cavallini and Casati [15] compared the effects of different washing solutions, DIPHOTERINE solution, normal saline (0.9 % NaCl), and calcium... 

DIPHOTERINE solution, boric acid, and tap water after 40 % sodium hydroxide exposure... 

DIPHOTERINE solution, sodium bicarbonate, and tap water after 95 % sulfuric acid exposure... 

Comparison criteria (see section Chemical reacting violently with water under Sect. 4.1.1.1 for details of the experimental protocol) were pH, temperature, and quantities of decontamination needed to reach a physiologically acceptable pH for macroscopic observations of the lesions. When the DIPHOTERINE solution is used, lesions are less severe, temperature increase is less, and it needs less solution to reach the physiological pH compared to tap water, sodium bicarbonate, or boric acid. 

In terms of evolution of the bum, the skin washed with 50 g/L sodium bicarbonate after 95 % sulfuric acid is scarlet this may be due to increased temperature when neutralizing, while after DIPHOTERINE solution washing, the trauma is dry and blood red. It may be due to lower temperature and hyperosmolarity, which better removes and reacts with sulfuric acid at the surface and preserves deeper tissue structure. The wound due to 40 % sodium hydroxide healed in 12 days after use of DIPHOTERINE solution, 16 days after use of 3 % boric acid, and 21 days after the use of water. 

All in aU, it is almost impossible, nowadays, to conduct clinical studies with optimal scientific criteria. Failing to perfectly, statistically prove the decrease in the severity of chemical lesions in comparing DIPHOTERINE solution versus tap... 

The DIPHOTERINE solution is able to change the pH of a corrosive solution quicker and under a volume much lower than water does, thus improving the return to an area of physiologically acceptable pH (experiments in vitro and ex vivo). 

Some case reports with DIPHOTERINE solution are described here. When decontamination is realized in emergency, as soon as possible, there are no sequelae (Table 4.8). 

Some studies have compared DIPHOTERINE solution with water or other flushing fluids. 

A Clinical Study in an Australian Facility Water Versus DIPHOTERINE Solution... 

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