Diphoterine® solutions skin decontamination

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... 

Diphoterine is a product for chemical spatters on the eye and skin. Prevor Laboratory in France manufactures this odorless, colorless liquid dispensed as an eye wash or skin decontamination spray. It is composed of an aqueous solution to wash many chemical families and pull hydrophilic chemical agents away from the surface of tissues, an amphoteric solution that acts on acids and bases and restores the tissue physiological pH, and a hypertonic solution that stops penetration of corrosive chemicals into tissues. The pH is slightly alkaline (pH 1.2-1.1) and is sterile. Although not classified as such in the USA, it is classified as a medical device in Europe, Canada, Australia, and Brazil (www.prevor.com). 

Mathieu, L., Burgher, F., Hall, A.H. (2007). Diphoterine chemical splash decontamination solution skin sensitization study in the guinea pig. Cutan. Ocul. Toxicol. 26 181-7. 

The workers either chose to have decontamination alkali skin chemical splashes with water first (n=42) or DIPHOTERINE solution first (n=138). There were no statistically significant differences between the two groups for the TBSA involved or for the elapsed time between chemical splash and clinical assessment. The median TBSA was 1 %, although a maximum of 38 % TBSA was observed [246]. There was no difference between the groups in term of the length of time that an alkali was on the surface of the skin. 

Thus, no chemical skin injury developed in 52.9 % of the workers who used DIPHOTERINE solution first for skin decontamination compared to 21.4 % who used water first, and only 7.9 % of workers who used DIPHOTERINE solution first had blistering or more severe chemical skin injury signs compared to 23.8 % who used water first [246]. 

The first was a study of 45 cases of sodium hydroxide or other strong bases (pH =14 or greater) in a German facility that produces aluminum oxide and aluminum hydroxide. A comparison was made between skin splash decontamination with water, acetic acid solution, and DIPHOTERINE solution. There was a significant reduction in lost work time with DIPHOTERINE solution decontamination as compared with the other two rinsing solutions, and no further treatment was required when DIPHOTERINE solution was utilized [249]. 

An epidemiological study of 145 eye/skin splashes with a variety of chemical substances including acids, alkalis, oxidants, solvents, and glues self-reported by occupational physicians was conducted by the French INRS (Institut National de Recherche et de Security, or National Institute for Research and Safety) [250-252]. DIPHOTERINE solution was found to be efficacious for decontamination of acids and alkali eye/ skin splashes, and its combination with water washing did not improve efficacy [253, 254]. Outcome endpoints such as severity of chemical injury, lost work time, and requirement for treatment other than initial decontamination were all improved when DIPHOTERINE solution was utifized as the initial washing solution [250-252]. 

With this case, we can show that delayed use of DIPHOTERINE solution (here more than 4 h) may be helpful in skin decontamination that allows spontaneous healing. 

Mathieu L, Buigher F, Blomet J. Comparative evaluation of the active eye and skin chemiceil splash decontamination solutions diphoterine emd hexafluo-rine with water and other rinsing solutions. J Chem Health Saf. 2007 4 32-9. 

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