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Scientific publications, studies and articles on DIPHOTERINE® solution

Title Article information Abstract
Is delayed decontamination with Diphoterine® solution useful in chemical injuries? Author(s): Dr Denise Jacquemin,
Date: November 2016
Source: APAMT Congress Singapour
Demonstrate the usefulness of delayed decontaminaton with Diphoterine® solution after chemical insult.
Date: November 2016
Source: APAMT Congress Singapour
Method: During 10 months period, chemical burns were registered. Water was used by patient within the first 10 minutes after exposure on site. Polyvalent solution was used 20 minutes after exposure upon arrival at clinic. When both rinsing solutions were used, water was used within 10 minutes after exposure and polyvalent solution after 30 minutes. The clinic being situated only 10 minutes away from the industrial area, some patients came to the clinic without first rinsing with water at accident site. Statistical analysis was performed following large or small samples according to the population. After 6 months’ study (70 cases), we noticed that the following elements could help improve outcome and they were introduced them from December onwards (40 cases): pain factor upon arrival versus pain factor when leaving clinic and visual acuity upon arrival versus visual acuity when leaving the clinic.
Date: November 2016
Source: APAMT Congress Singapour,
Objectives: Compare treatment results obtained from different first aid managements using water and/or polyvalent hypertonic amphoteric first-aid solution stopping corrosive reactions registered as a Medical Device.
Base (Sodium Hydroxide; NaOH) Skin Injury and Decontamination: In vitro, Experimental Animal, and Human Skin Explant Ex Vivo Studies Author(s): Hall AH,
Date: 2011-03
Source: 44th scientific annual meeting of the BBA (British Burn Association), March 2011, Salisbury, Royaume-Uni,
In vitro, ex vivo and animal studies on cutaneous injuries due to sodium hydroxide are presented in this poster. These studies confirm the need of a fast and effective decontamination in order to prevent or limit lesions spreading. Presented results support previous studies and the clinical use of the Diphoterine® solution as a decontamination solution in cases of cutaneous sodium hydroxide splashes. Mathieu L1, Wang H-f2, Zhang F3, Fosse C1, Coudouel H1, Lati E4, Peno-Mazzarino L4, Bouzard D4, Hall AH5,6 1HSE Solutions Laboratory, Valmondois, France; 2Department of Fire Engineering, The Chinese People’s Armed Forces Police Academy, Langfang, Heibei Province, China; 3Tianjin No. 1 Special Firefighting and Rescue Detachment, Tianjin, China; 4BIO-EC Laboratory, Clamart, France; 5Toxicology Consulting and Medical Translating Services, Inc., Laramie, Wyoming, USA; 6Colorado School of Public Health, Denver, Colorado, USA
Amphoteric Compound Chemical Eye/Skin Splash Decontamination: Clinical Experience [Décontamination chimique cutanée ou oculaire avec un compose amphotère : experience Clinique] Author(s): Blomet J,
Date: 2011-09
Source: 14th EBA (European Burn Association) congress, September 2011, Den Hague, The Netherlands,
Oral presentation whose objective was to extend the data previously published with the spontaneous feedbacks from customers on the use of an amphoteric solution, Diphoterine®. Among 44 feedback cases, sodium hydroxide and sulphuric acid were the most frequent implied chemicals in industrial accidents. In this not randomized case series, washing with Diphoterine® solution was associated with good clinical outcomes. Hall AH1, Mathieu L2, Burgher F2, Fosse C2, Blomet J2 1Toxicology Consulting and Medical Translating Services, Inc., Laramie, Wyoming, USA and Colorado School of Public Health, Denver, Colorado, USA, 2Laboratoire HSE Solutions, Valmondois, France
A systematic review of methods of eye irrigation for adults and children with ocular chemical burns Author(s): Suzanne Lo,
Date: 2011-06
Source: Worldviews on Evidence-Based Nursing, 7 juin 2011, [Epub ahead of print],
The authors have decided to present a systematic review based on English and Chinese literatures regarding the different washing solutions available when faced with an ocular chemical splash. This review includes Diphoterine® solution yielded positive ocular outcomes suggesting for its use in hospital settings. Janita PC Chau, Diana TF Lee, Suzanne Lo Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
Sodium hydroxide – Management of ocular and cutaneous chemical splashes Author(s): L. MATHIEU,
Date: 2011
Source: PREVOR
Study on the decontamination of sodium hydroxide. This publication contains different comparative data between Diphoterine® and tap water or saline. In vitro studies, using a new model to evaluate the irritant or corrosive potential of chemicals and effectiveness of decontamination, show a rapid return to physiological pH with Diphoterine®. Several in vivo studies: • The first shows that using Diphoterine®, the process of chemical skin lesion is stopped and tissue repair improved. • A second shows that Diphoterine® limits the increase of pH due to sodium hydroxide exposure, preventing thus a stromal edema development. These results are in accordance with results obtained in the industrial world and with a clinical study on ocular alkali injury showing a period of re-epithelialization shortest with Diphoterine® (versus saline).
Sulphuric acid burn: Evaluation and decontamination Author(s): Mathieu L, Fosse C, Coudouel H, Hall AH,
Date: 2010
Source: British Burn Association annual meeting, East Grinstead, UK, avril 2010,
This poster describes results of an ex vivo study on human skin explants exposed to 95% sulphuric acid as well as of in vitro experiments on the acid diffusion and its decontamination. From the first minute, alterations are observed on the explants, on the epidermis layer. Skin penetration is complete in only 4 hours with this ex vivo model. In vitro experiments show that the mechanical flushing effect at the tissue surface is the main washing effect. Dilution effect is the minor effect. The chemical effect, bring by a solution such as Diphoterine®, helps to improve the surface mechanical effect. Thus, a more rapid return to pH normalisation is promoted, compared to a tap water washing.
Chapter 64 – Irritant Incapacitant Exposure Author(s): P Buttaravoli
Date: 2007
Source: Minor Emergencies: Splinters t fractures, 2nde Edition, Mosby Elsevier, 2007 – p249-251,
Description of the procedures to apply if a person or more came to the emergency department with an irritant incapacitant agent exposure. Presentation of Diphoterine® has an interesting potential decontamination solution.
Ophtalmologic Procedures in the Emergency Department Author(s): Babineau MR, Sanchez LD
Date: 2009
Source: Emergency Medicine Clinics of North America, 2008 (26): 17-34,
This publication gives procedures to apply in the Emergency department in case of an ocular irritant exposure and names Diphoterine® as a potential rinsing solution (p.28, paragraph 4, “eye irrigation”): “The preferred buffer solutions are amphoteric (universal) buffers that may help to limit further damages to the eye caused by exothermic chemical reaction between the irrigant and the offending agent. Ethylenediaminetetracetic acid (EDTA) used to be the primary amphoteric buffer, but has now been largely replaced by Diphoterine®”. The impact of the osmolarity of the rinsing is also mentioned.
Decontamination of tetramethylammonium hydroxide (TMAH) splashes: promising results with Diphoterine in vitro Author(s): Fosse C, Mathieu L, Hall AH, Bocchietto E, Burgher F, Fischbach M, Maibach HI.
Date: 2010
Source: Cutaneous and Ocular Toxicology. 2010 June;29(2):110-115,
TMAH, used in microelectronic industries and research and development, has both corrosive and toxic properties. 2 fatal exposures have been already published. This publication presents results of in vitro comparative studies between an initial washing with Diphoterine® and a tap water rinsing: a pHmetric assay and a cytotoxicity test (MTT test). For pH normalisation, 17 times more tap water than Diphoterine® was required. In the cytotoxicity test, 2/3 of the cells remained viable after Diphoterine® washing, compared with only 1/3 after tap water washing. So Diphoterine® washing compared to tap water washing seems effective to prevent injuries from TMAH exposure.
Diphoterine for alkali chemical splashes to the skin at alumina refineries Author(s): Michael Donoghue
Date: 2010
Source: International Journal of Dermatology, 2010; 49:894-900,
This publication presents the study performed by the company Alcoa in Australia on three alumina refineries, in order to validate the implementation of Diphoterine®. This study includes two parts: the first one is a comparative clinical study between a group of people who applied Diphoterine® first and a group applying tap water first, among 180 cases. The second part compares the injury rate before and after Diphoterine®’s setting up. The implementation of Diphoterine® helped not only to reduce the underlying accident frequency, and so it increases the prevention message to workforce, but more than anything, it helped to reduce significantly severity of injury, or even to eliminate it.
Management of ocular surface chemical burns Author(s): Gicquel JJ
Date: 2010
Source: British Journal of Ophtalmology, November 2010, doi: 10.1136/bjo.2010.187104,
Diphotérine® is cited as a possible washing solution that can be used in cases of alkali ocular splashes. This citation referred to H. Merle et al.’s study performed in French West Indies and published in Burns in 2005. The different therapeutical protocols to apply, depending on Dua’s classification, are also available.
Chemical burns: Pathophysiology and treatment Author(s): R. Palao , I. Monge, M. Ruiz, J.P. Barret
Date: 2009
Source: Burns, juillet 2009, epub. 3133, 10 pages,
A review of the physiopathology of chemical burns and their treatment. Diphoterine® appears to be a promising decontamination solution. Studies on the subject should be developed.
Safety of dermal Diphoterine application: an active decontamination solution for chemical splash injuries Author(s): Hall A.H. et al
Date: 2009
Source: Cutaneous and Ocular Toxicology. 2009;28(4):149-56,
All reports and studies currently available published or not, on the innocuousness of Diphoterine® for dermal application, are reviewed. Cutaneous toxicology studies have recently been made to supplement the existing data, and thus show that there are no cutaneous harmful effects. This supports the conclusion that Diphoterine® can be used without toxic, irritation, allergic or sensitization effects, including on skin lesion. These results are promising for the development of a protocol for the delayed cutaneous washing of chemical splashes to complement the existing protocol for immediate use.
Dynamic analysis of chemical eye burns using high-resolution optical coherence tomography Author(s): N. SCHRAGE,
Date: 2007
Source: Journal of Biomedical Optics, July/August 2007,12 (4), 041203
This publication evaluates the use of high-resolution optical coherence tomography (OCT) to visualize penetration kinetics during the initial phase of chemical eye burns. It demonstrates the potential of HR-OCT for the visualization and direct non-invasive measurement of specific interaction of chemical with the eye. This capacity shows the effectiveness of an active washing solution, Previn® (the German version of Diphotérine®) when compared to not rinsing at all, on a splash due to caustic soda.
Diphotérine® Chemical Splash Decontamination Solution: Skin Sensitization Study in the Guinea Pig Author(s): A. H. HALL,
Date: 2007
Source: Cutaneous and Ocular Toxicology, 2007, N°26, 181-187
Diphotérine® was evaluated for its sensitization potential in the guinea pig with primary induction (day 1, intra dermal injection), sensitization (day 9, topical application), and challenge (day 22, topical application). No irritation was noted at 24 and 48 hours in negative controls and in animals. Diphotérine® showed no allergenicity reaction after 24 and 48 hours. Diphotérine® appears to have no sensitizing capacity in the guinea pig.
Diphoterine for emergent decontamination of skin/eye chemical splashes : 24 cases Author(s): J. BLOMET, 
Date: 2006
Source: Cutaneous and Ocular Toxicology, 2006, 25, 249-258
Feedback from a German metallurgy company concerning 24 cases of ocular and / or cutaneous projections, from either acids or bases. After the use of the Diphotérine®, there were neither burns nor after-effects, and no need for secondary care.
Emergency treatment of eye burns: which rinsing solution should we choose ? Author(s): R. RIHAWI,
Date: 2006
Source: Graefe’s Arch Clin Exp Ophtalmol, juillet 2006, 244(7), 845-854,
This comparative study tests by in vitro and ex vivo methods of pH measurements, various solutions of ocular washing on a sodium hydroxide projection (2M) : water, saline solution, Cederroth® (borate buffer solution), Previn®, Diphotérine®, Ringer lactate and a phosphate buffer solution. The authors recommend using an active solution on alkaline projections noting that an isotonic phosphate buffer solution does not have an effect on the intra-ocular pH. Previn®, Diphotérine® and Cederroth® are more effective than water in returning the pH of the anterior chamber to an acceptable zone.
Alkali ocular burns in Martinique (French West Indies). Evaluation of the use of an amphoteric solution as the rinsing product Author(s): H. Merle
Date: 2005
Source: Burns, 2005, 31, 205-211
This publication describes the clinical study, conducted in Martinique, French West Indies, of alkali ocular burns. It concerns chemical eye burns with delayed Diphoterine® rinsing, compared with saline solution, followed by a specific treatment adapted to the seriousness of the case. 28 patients (42.4%) had a unilateral burn, and 38 (57.6%) a bilateral one. Amongst the circumstances of the burns, sorted by order of decreasing frequency, one finds: assaults in 45.5% of the cases (n = 30), work related accidents (32%, n = 21) and domestic incidents (23%, n = 15). For grade 1 and grade 2 burns, reepithelialization time is shorter when rinsing has been done with Diphoterine®: 1.9 ? 1 days, compared with 11.1 ? 1.4 days (p = 10-7) and 5.6 ? 4.9 days compared with 10 ? 9.2 days (p = 0.02).
Prevention of CS “Tear Gas” Eye and Skin Effects and Active Decontamination with Diphoterine®: Preliminary Studies in 5 French Gendarmes Author(s): A. H. HALL,
Date: 2005
Source: Journal of Emergency Medecine, 2005, 29, 1, 5-8
Ortho-chlorobenzylidine malononitrile (CS) “tear gas” is a lacrimating riot control agent causing eye irritation, excessive lacrimation , and blepharospasm. Diphoterine® rinsing was used in human volunteers for : 1) post-exposure decontamination of CS and 2) pre-CS exposure prophylaxis in the eyes and on the face. Five French Gendarmes were exposed to CS in an exposure chamber. For post-exposure, volunteers developed the expected effects of excessive lacrimation, eye irritation and blepharospasm. These effects were rapidly resolved after Diphoterine® rinsing. For pre-CS exposure, Diphoterine® was applied to the eyes and face and the expected effects of CS did not occur. Based on the preliminary data presented here, Diphoterine® may be an efficacious eye and skin prophylactic and decontamination solution for CS exposure and further studies are warranted.
Diphoterine®: skin sensitization study in the guinea pig Author(s): AH. HALL,
Date: 2004
Source: ICT congress, ampere, Finlande, Juillet 2004 SOT, Mars 2004, Baltimore, MD, USA,
Since 1999, a supervision of the market was organized by HSE Solutions Laboratory in order to collect the complaints from the users : no case of sensitization with Diphotérine® was reported by the companies. A sensitization study was realised to confirm this observation and to add a new proof of the Diphotérine®‘s innocuousness. The capacity to induce a delayed sensitization was evaluated for the pig (Guinea) according to OCDE recommendations and 67/548/EEC directive. The study was realized by CERB Laboratory, Baugy, France (Report of study n° 20030418ST). The test was realized according to Magnusson-Kligman and Guillot’s method.
A review about Diphotérine®: the solution for first aid emergency decontamination of eye/skin chemical splashes. Author(s): F. SIMON,
Date: 2003
Source: ISSA Congress – May 2003, Athens, Greece,
METHODS: we present here the different significant results obtained with Diphotérine® during the last twelve years in the industry.
Emergency treatment of chemical and thermal ocular burns. Author(s): G. KELLER,
Date: 2002
Source: Acta Ophthalmologica Scandinavia 2002, 80, 1, 4-10,
Water is hypotonic to the corneal stroma. The osmolarity gradient causes an increased water influx into the cornea and the invasion of corrosive substance into deeper corneal structures. We therefore recommend higher osmolarities for the initial rinsing to mobilize water and the dissolved corrosives out of the burnt tissue.
Comparison of emergency eye-wash products in burned porcine eyes. Author(s): N.SCHRAGE,
Date: 2002
Source: Graefe’s Arch Clin Exp Ophthalmol 2002,
The long term prognosis of patients with chemical eye burns depends on immediately rinsing the eye after the trauma. The emergency treatment after the burn should consist of rinsing with a solution of a high buffer capacity and with a high osmolar difference in comparison with the cornea.
Experimental immunological study in chemical burns in rats. Author(s): M. CAVALLINI,
Date: 2002
Source: SOT – March 2002 SFETB – September 2001,
Amphoteric solution (Diphoterine®) showed satisfactory results not only in immunological responses but also in wound healing and pain control (high level of b -endorphin, and low level of substance P), in comparison with other solutions used
Interest of Diphotérine® as an ocular rinsing solution for the emergency treatment of serious ocular burns. Author(s): N. SCHRAGE,
Date: 2002
Source: SFO Congress – May 2002,
This presentation reports a case of serious eye burn (grade IV of Ropper Hall’s classification) healed by a simple conservative therapeutic regimen, preceded by an initial rinsing with one litre of Diphoterine®, one hour after the accident.
Diphotérine® for emergent eye-skin chemical splash decontamination : a review. Author(s): J. BLOMET,
Date: 2000
Source: Semi Conductor and Safety Association European Congress October 2000, Milan,
This text summarizes the different European experiences and studies carried out on the action of Diphotérine® on chemical burns and its efficiency. It also evokes the testimonies of companies satisfied with Diphotérine®. In conclusion, Diphotérine® appears as a major improvement in the field of the emergency rinsing of splashes due to chemical products.
A review about Previn® (Diphotérine®) : A solution for first aid emergency decontamination of eye/skin chemical splashes. Author(s): J. NEHLES,
Date: 2000
Source: International Congress on Environmental Health October 2000, Germany,
This poster presents all the results obtained with Previn® (Diphotérine®) in Germany. These results show the Previn® (Diphotérine®) efficiency for the decontamination of ocular and cutaneous splashes. A decrease of the loss of work and secondary care is noticed in all cases.
A review about Diphotérine® : the solution for emergency decontamination of chemical splashes. Author(s): H. UELLNER,
Date: 2000
Source: Eurotox 2000 London,
The testimony of Diphotérine® users allowed to assemble about ten ocular or cutaneous splashes, rinsed efficiently with Diphotérine®. We notice the absence of sequelae, and a decrease of secondary care and loss of work.
A review about Diphotérine® : the solution for emergent decontamination of eye / skin chemical splashes. Author(s): J. NEHLES,
Date: 2000
Source: Occupational Hygiene 2000 Manchester,
The use of Diphotérine® is a good system for the emergency treatment after splashes with chemical products. It permits to decrease the number of days lost from work and the secondary care and also the after-effects for the injured persons.
New physiological approach of digestive burns due to ingestion of caustic products. Therapeutical experimental interest of Diphotérine®. Author(s): S. BARATTE,
Date: 1999
Source: 37th European congress of toxicology Eurotox 1999 Oslo,
In vivo study carried out on an animal model (pig) that permits to valuate the evolution of oesophagus cautic burns and to create a decontamination method with Diphogel® in a pHmetric, endoscopic and histologic way. Diphogel® reestablishes without any delay the physiological pH at mucous membranes level and muscular membranes level. This study shows an immediate tissue decontamination of the caustic by stopping the burn at its injural level.
Critical methods of the antidotes valuation. Author(s): F. BAUD,
Date: 1999
Source: 1st Prever scientific daytime April 14th 1999, Paris,
The clinical study is the sole valuation that is really reliable regarding the capacity of “antidotes”.
Hyperosmolar Rinsing as First Aid in Eyes Burns? Author(s): S. KOMPA,
Date: 1999
Source: 37th toxicology european congress Eurotox 1999 Oslo,
The study on 10 sane humans shows that the use of PREVIN® (Diphotérine®) as an hypertonic solution dedicated to the emergency ocular rinsing is not dangerous for the health : complete recovery of physiological capacities after 3 days. As a consequence the hypertonicity is a characteristic to use for the emergency ocular decontamination.
OSWI 10th annual congress. Author(s): P. JOSSET,
Date: 1999
Source: West Indian Medical Journal July 1999,
This abstract summarizes 3 studies titled : “Ocular alkali burns : limbal autograft”, “Ocular ammoniac burns : treatment” and “Intraocular penetration of toxic substances”.
Evaluation of the decontaminating activity of Diphotérine®. Author(s): Col. P GERASIMO,
Date: 1999
Source: Radiological protection Department from the French Army.
The valuation of the efficiency of Diphotérine® for the decontamination of mustard gas gave satisfactory results compared to the results obtained with soapy water and physiological serum. After a ten minutes rinsing, the tests show that Diphotérine® decontaminates twice faster than physiological serum and 4 times faster than soapy water.
Diphotérine® : multi-purpose solution for the decontamination. Author(s):
Date: 1999
Source: PREVOR
In case of chemical or radiological disasters, the most important is to avoid the transfer of the injured persons towards the reception structures dedicated to the victims. All the studies summarized in this file show that Diphotérine® is the efficient solution that is able to decontaminate all the toxics : classical chemical products, products used as chemical weapons (blister gas, neurotoxics, radioactive products…).
Chemical burns : place of Diphotérine®. Author(s): P. BROCHARD,
Date: 1998
Source: Society of Occupational and ergonomics medicine from Bordeaux and its area.,
The treatment of the chemical burn is an emergency that must be done on the places of the accident. Diphotérine® seems to be a promising alternative front to the lack of efficiency of water in case of chemical burns. Several results from experimental and industrial studies show the superiority of a rinsing with Diphotérine® compared to the classical methods of rinsing. The action mechanism of Diphotérine® that is multiple permits an action with the corrosives without exothermic reaction linked to a fast pain relief. Its light hypertonicity permits to be influent on the penetration of the corrosive inside our tissues.
Valuation of the first aid efficiency in case of splashes with chemical products. Author(s): F. FALCY,
Date: 1997
Source: INRS DMT 70,
This report is the next of the survey (INRS DMT 53) concerning the addition of the accidents obtained by the occupational doctors after ocular and cutaneous splashes with chemical products.