Monday, June 8, 2015

Potassium Permanganate: Dosing & Dilution

Available: potassium permanganate 0.1%
  • All doses are suitable for adults and children.
Suppurating superficial wounds and tropical ulcers:
  • A 1:7-1:10 dilution of the stock solution is used in wet dressings (a concentration of 0.01%). The dressings should be changed twice or 3 times daily. For tropical ulcers, a 2- to 4-week course of treatment with procaine benzylpenicillin is also required
Tinea pedis:
  • Severe weeping lesions should be soaked in a 1:10 dilution of the stock solution every 8 hours.
Pemphigus:
  • Compresses soaked in a 1:7-1:10 dilution of the stock solution are applied every 4 hours.
Impetigo:
  • Superficial crusts should be gently separated with a 1:10 dilution of the stock solution.
Dosing recommendation by Use
Bath Fill
  • a tubful with the solution and use for bathing.
Compress Moisten strips of cotton or gauze in the solution.
  • Wrap the strips around the affected areas. Keep the strips in place for 10 minutes. If they dry out, add more solution.
Soak Fill
  • a bathtub or a basin with enough solution to immerse the affected areas. Soak for about 10 minutes.
Wash Dip
  • cotton or a gauze in the solution and use to wash affected areas.
Concentrated Solution
  • Most recommendations suggest use of solution of 0.01% for wound
  • However, some recommends a solution of 1 in 1000 (0.1%) may be used as wet soaks to blistering wounds such as ulcers and abscesses.
  • Strips of cotton or gauze should be soaked in the solution and wrapped around the affected area for 20-30 minutes.
  • The astringent action of potassium permanganate helps to dry out the blister and prepare the wound for other treatment
  • This suggestion has to be taken with caution as higher concentration of permanganate is caustic/may damage growth of newer tissue
Precautions
  • Dressings should not be applied under plastic or rubber occlusion.
  • Do not make solution too concentrated or use crystals directly on affected areas as these will irritate and burn the skin.
  • Dab dry after use. It is not necessary to rinse off with clean water.
  • Use either warm or cool water to make the solution.
Adverse effects
  • Skin irritation is common. Brown staining of the skin also occurs.
Storage
  • Solutions should be stored in well-closed containers, protected from light.
References:
  1. WHO Model Prescribing Information: Drugs Used in Skin Diseases
  2. http://www.dermnetnz.org/treatments/permanganate.html
  3. http://www.pss.org.sg/sites/default/files/public-resource/Potassium%20Permanganate_0.pdf

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