Dextranomer

(BAN, rINN)
Dextranomer Chemical formula
Synonyms: Dekstranomeeri; Dextranomère; Dextranómero; Dextranomerum. Dextran cross-linked with epichlorohydrin (1-chloro2,3-epoxypropane); Dextran 2,3-dihydroxypropyl 2-hydroxy1,3-propanediyl ether.
Cyrillic synonym: Декстраномер.

💊 Chemical information

CAS — 56087-11-7.
ATC — D03AX02.
ATC Vet — QD03AX02.

Pharmacopoeias.

In Eur..

Ph. Eur. 6.2

(Dextranomer). White or almost white, spherical beads. Practically insoluble in water. It swells in water and electrolyte solutions

💊 Adverse Effects and Precautions

Dextranomer can cause pain during dressing changes in some patients, and bleeding, blistering, and erythema have been reported occasionally. It should not be used in deep wounds or cavities from which it cannot be easily removed, nor should it be used on dry wounds. Care should be exercised when paste formulations of dextranomer are used near the eyes. Spillage may render surfaces very slippery. Viscous gel implants containing dextranomer, injected submucosally around the urethra, can cause transient urinary retention. Injection site reactions including mass, abscess, and pseudocyst formation have been reported.

💊 Uses and Administration

The action of dextranomer as a wound dressing depends upon its ability to absorb up to 4 times its weight of fluid, including dissolved and suspended material of molecular weight up to about 5000. Dextranomer is used for the cleansing of exudative and infected burns, wounds and ulcers, and for preparation for skin grafting. The wound is cleansed with sterile water or saline and allowed to remain wet; dextranomer in the form of spherical beads is sprinkled on to a depth of at least 3 to 6 mm and covered with a sterile dressing. Occlusive dressings are not recommended as they may lead to maceration around the wound. The dextranomer can be renewed up to 5 times daily (usually once or twice daily) when the layer has become saturated with exudate; the old layer is washed off with a stream of sterile water or saline before renewal. All dextranomer must be removed before skin grafting. Dextranomer may also be applied as a paste (either ready-made or prepared by mixing dextranomer beads with glycerol). Implants containing dextranomer microspheres in a stabilised hyaluronic acid carrier gel (NASHA/Dx) are available for injection. In female stress urinary incontinence, 4 injections each containing 35 mg of dextranomer are injected into the submucosa of the urethra. Connective tissue gradually surrounds the microspheres, and the resulting augmented tissue helps to restore urinary continence. A second implantation may be performed if necessary, but no sooner than 6 weeks after the first. In vesicoureteral reflux in children, up to 50 mg may be injected into the submucosa of the ureter, creating a bulge close to the ureteral orifice. The procedure may be repeated after 3 months if necessary.
1. Stenberg ÅM, et al. Urethral injection for stress urinary incontinence: long-term results with dextranomer/hyaluronic acid copolymer. Int Urogynecol J 2003; 14: 335–8
2. van Kerrebroeck P, et al. Efficacy and safety of a novel system (NASHA/Dx copolymer using the Implacer device) for treatment of stress urinary incontinence. Urology 2004; 64: 276–81
3. Chapple CR, et al. An open, multicentre study of NASHA/Dx Gel (Zuidex ) for the treatment of stress urinary incontinence. Eur Urol 2005; 48: 488–94
4. Dean GE, Doumanian LR. The extended use of Deflux (dextranomer/hyaluronic acid) in pediatric urology. Curr Urol Rep 2006; 7: 143–8
5. Routh JC, et al. Single center experience with endoscopic management of vesicoureteral reflux in children. J Urol (Baltimore) 2006; 175: 1889–93
6. Yu RN, Roth DR. Treatment of vesicoureteral reflux using endoscopic injection of nonanimal stabilized hyaluronic acid/dextranomer gel: initial experience in pediatric patients by a single surgeon. Pediatrics 2006; 118: 698–703.
m n n

💊 Preparations

Proprietary Preparations

Belg.: Debrisan†; Ger.: Debrisorb†; Hong Kong: Debrisan†; Hung.: Crupodex†; Irl.: Debrisan†; Ital.: Debrisan; Mex.: Debrisan†; Pol.: Acudex; S.Afr.: Debrisan; UK: Debrisan†; USA: Debrisan. Multi-ingredient: UK: Zuidex; USA: Deflux.
Published November 23, 2018.