Hello bakemi,
I believe that the cream you are looking for is Aserbine, made by
Goldshield, a UK company, which is used for debridement of ulcers.
According to the British National Formulary, Aserbine cream contains
benzoic acid 0.025%, malic acid 0.375%, propylene glycol 1.75%,
salicylic acid 0.006%.
http://bnf.vhn.net/bnf/documents/bnf.2512.html#BNFID_6293
Its presence in the BNF means it is definitely available in the UK.
However, a search of a couple of UK online pharmacies known to me did
not find it in their catalogues, possibly because it is an uncommon
medication.
I went to the Goldshield website to find out more, and discovered that
the active agent is malic acid
http://www.goldshield-pharmaceuticals.com/UnitedKingdom.htm
I could not find any mention of Aserbine on http://www.rx.com nor in
the drug information section of Medline Plus http://medlineplus.gov/
I conclude from this that Aserbine is not available in the US.
This is confirmed by the fact that Goldshield has no presence in North
America. However, they do have distributors for their products in the
UK, Europe, Australasia, Asia and Africa
http://www.goldshield-pharmaceuticals.com/Contact.htm
Perhaps you may be able to find a local supplier for your mother if
you contact Goldshield.
A paper on wound dressing by Dr Stephen Thomas, Surgical Materials
Testing Laboratory, Bridgend District and NHS Trust, UK, mentions
Aserbine, but says it is not widely used by wound care specialists
http://www.worldwidewounds.com/1997/july/Thomas-Guide/Dress-Select.html
Perhaps this is why your mother was unable to find it. If she was
asking for Ascerdine, the pharmacist might not be familiar enough with
Aserbine (if it is not prescribed very often) to make the connection.
A search to see if there other products containing malic acid which
are used for the same purpose did not give any results.
I went back to the paper by Dr Thomas, who mentions the following
treatments:
“Probably the first modern dressing to be marketed specifically for
use as a wound cleansing agent was the polysaccharide bead dressing
Debrisan (Pharmacia Ltd). When applied to relatively small moist
sloughy wounds the beads absorb fluid and progressively move bacteria
and cellular debris away from the surface of the wound. Iodosorb
(Perstorp) although similar to Debrisan in appearance, also contains
elemental iodine which is liberated to exert an antibacterial effect
in the wound when the dressing absorbs liquid. Both Debrisan and
Iodosorb are also produced in the form of pastes or ointments.
Iodoflex consists of layer of Iodosorb paste which is applied to the
wound on a gauze fabric carrier as a treatment for infected wounds
such as leg ulcers. Shallow sloughy wounds which produce limited
amounts of exudate can be treated with a hydrocolloid dressing that
facilitates autolysis by the mechanisms described previously. Sloughy
wounds which also produce a degree of exudate may be dressed with
alginate dressings such as Sorbsan (Maersk), Tegagen (3M Health Care
Ltd), Kaltostat (Convatec Ltd) or other gel forming polysaccharide
dressings such as Aquacel (Convatec Ltd)… Other materials which are
sometimes used to debride sloughy wounds include enzymatic agents such
as Varidase (Lederle Laboratories), crab collagenase and krill”
I then had a look at some of the products mentioned:
http://www.rx.com does list Iodosorb 0.9% gel and 0.9% pad, but has no
patient information available. Likewise for Debrisan paste and
Debrisan beads, and for Accuzyme 10% ointment. Varidase is not
listed, but another enzyme-based treatment, Accuzyme, is, although
with no patient information, as is Panafil, but with no information.
(Accuzyme and Panafil are both based on the enzyme papain). None of
the dressings mentioned are listed.
Iodosorb, Accuzyme and Panafil are all marketed by Healthpoint
http://www.healthpoint.com
Information on Iodosorb is available at
http://www.healthpoint.com/content/tissue/tissue_iodosorbflex_prescrib.htm
(“Federal law restricts this device to sale by or on the order of a
physician or other licensed health care practitioner.”)
Accuzyme information is available at
http://www.healthpoint.com/content/tissue/tissue_accuzyme_prescrib.htm
(only available on prescription)
Panafil: http://www.healthpoint.com/content/tissue/tissue_panafil_prescrib.htm
(only on prescription)
None of these products are an exact substitute for Aserbine, and all
need a prescription. If you are unable to find a supplier of Aserbine
in your mother’s country, you will need to get her to discuss the
matter once more with her doctor, to see if he is willing to write a
prescription for one of these products or to suggest something
completely different.
Search strategy: debridement ulcers diabetes
This led me to a document “Pressure Sores, Leg Ulcers, Hypothermia and
Immobilisation” by Jeff Hughes from Curtin University, Australia
http://web.health.curtin.edu.au/Pharm/GP527/struc_content/lectures/9.%20Ulcers%20&%20Pressure%20Sores.pdf
(Be warned, that the illustrations of sores and ulcers in this
document are not for the squeamish!). Aserbine was mentioned in the
treatment of ulcers. It sounded so like the substance you are seeking,
so I carried out a second search on “Aserbine”, and then one on
“Goldshield”. This was followed with a search on: “malic acid”
debridement, and on “malic acid” ulcers. I then searched on
individual names of medications mentioned in the Thomas paper. |
