{"id":9595,"date":"2026-08-10T22:50:29","date_gmt":"2026-08-10T22:50:29","guid":{"rendered":"https:\/\/majistraleczacilari.org.tr\/?post_type=docs&p=2233"},"modified":"2026-08-21T11:43:34","modified_gmt":"2026-08-21T11:43:34","password":"","slug":"fish-oil-ointment-in-burn-treatment","status":"publish","type":"docs","link":"https:\/\/majistraleczacilari.org.tr\/en\/dokumanlar\/antipruritic-anti-inflammatory-astringent-keratolytic-cicatrizing-steroid\/fish-oil-ointment-in-burn-treatment\/","title":{"rendered":"\u2019Fish Oil Ointment\u2019 in Burn Treatment"},"content":{"rendered":"
Dear Colleagues, this week we will examine together a formulation included in the Dutch National Formulary (FNA) and used in the treatment of 1st and 2nd degree burns.<\/div>\n
\n

Before moving on to our formula, it will be useful to briefly review the topic of burns.<\/p>\n

Classification of Burns<\/strong><\/p>\n

Burns are divided into 3 categories according to their depth.<\/p>\n

1- <\/strong>First-Degree Burns: This is the type where only the superficial skin is damaged, characterized by redness and mild pain on the skin. Sunburn is a good example of this type. It can heal on its own in a short time.<\/p>\n

2- Second-Degree Burns: These are burns mostly caused by scalding with hot water, contact with flames, or hot objects. In addition to redness on the skin, blisters are seen. They are very painful burns that are prone to infection.<\/p>\n

3- Third-Degree Burns: This is the type of burn where all skin layers are affected. Since nerve endings are also destroyed, pain is minimal. There is a color change such as pearl gray \u2013 brown. The skin is dry and leathery\/wrinkled. Healing takes a very long time and leaves scars.<\/p>\n

Rule of Nines: <\/strong>The extent or surface area covered by the burn can be roughly estimated using the rule of nines system. This system divides the body surface area into sections, each representing approximately 9% of the total body surface area. Since the head constitutes a larger portion of the body and the legs constitute a smaller portion in infants and children, the proportions differ in children compared to adults.<\/p>\n

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Severity of Burns<\/strong><\/p>\n

5 factors determine the severity of burns.<\/p>\n

1-<\/strong>    Depth (first, second, third degree)<\/p>\n

2-<\/strong>    Surface area (rule of nines)<\/p>\n

3-<\/strong>    Burns in critical areas (hands, feet, face, genitals)<\/p>\n

4-<\/strong>    Age of the casualty (being very young or very old)<\/p>\n

5-<\/strong>    General health status of the casualty (other injuries and pre-existing medical conditions)<\/p>\n

These five factors enable the first responder to determine whether the burn is severe, moderate, or minor.<\/p>\n

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Severe Burns: <\/strong>These are the most critical burns.<\/p>\n

1-<\/strong>   Burns involving critical areas such as hands, feet, genitals, and face<\/p>\n

2-<\/strong>   Burns accompanied by respiratory distress or fractures (regardless of their degree)<\/p>\n

3-<\/strong>   3rd-degree burns covering more than 10% of the body surface area<\/p>\n

4-<\/strong>   2nd-degree burns covering more than 25% of the body surface area<\/p>\n

5-<\/strong>  Burns covering more than 30% of the body surface area, regardless of degree<\/p>\n

6-<\/strong>   Burns in the elderly, critically ill patients, and children are evaluated as severe burns because they are highly susceptible to fluid loss.<\/p>\n

7-<\/strong>  Burns caused by all agents other than direct heat contact and scalding (acid, electricity, chemicals, radiation) are evaluated as severe burns, regardless of the surface area.<\/p>\n

Moderate Burns: <\/strong>Although they are less dangerous than severe burns, they are still serious injuries.<\/p>\n

1-<\/strong>  3rd-degree burns covering 2-10% of the body surface area (excluding hands, feet, and genitals)<\/p>\n

2-<\/strong>  2nd-degree burns covering 15-25% of the body surface area<\/p>\n

3-<\/strong>  1st-degree burns covering 50-75% of the body surface area<\/p>\n

Minor Burns:<\/strong><\/p>\n

1-<\/strong> 3rd-degree burns covering less than 2% of the body surface area<\/p>\n

2-<\/strong> 2nd-degree burns covering less than 15% of the body surface area<\/p>\n

Burn Severity in Children:<\/strong><\/p>\n

1-<\/strong>  A 2nd-degree burn covering more than 20% of the body surface area is severe.<\/p>\n

2-<\/strong>  Any 3rd-degree burn is severe.<\/p>\n

3-<\/strong>  A 2nd-degree burn covering 10-20% of the body surface area is moderate.<\/p>\n

4-<\/strong>  Any 1st-degree burn is moderate.<\/p>\n

Formula:<\/strong><\/p>\n

Rp.<\/strong><\/p>\n

Iecoris aselli oleum         20 g<\/strong><\/p>\n

Zinci oxidum                      30 g<\/strong><\/p>\n

Kaolinum ponderosum      15 g<\/strong><\/p>\n

Adeps lanae                       25 g<\/strong><\/p>\n

Solutio caclii hydroxidi      10 g<\/strong><\/p>\n

Substances included in the formula:<\/strong><\/p>\n

Cod liver oil [BAN1999; INCI; P.Cx.79; USP]- Morina bal\u0131\u011f\u0131 karaci\u011fer ya\u011f\u0131- Morrhuae oleum;<\/strong><\/p>\n

Cod liver oil is obtained from the livers of Atlantic cod (Gadus morhua) and other species of the Gadidae family. It is used as a dietary supplement. As with most fish oils, it contains high amounts of omega-3 fatty acids (eicosapentaenoic acid, EPA and docosahexaenoic acid, DHA). Cod liver oil also contains vitamin A and vitamin D. In the past, cod liver oil was frequently utilized as a rich source of vitamins A and D. It was used especially for the treatment of rickets and symptoms associated with vitamin D deficiency in children. The oil has also been widely used to relieve joint pain and symptoms associated with arthritis. Cod liver oil can help repair damaged skin, hair, nails, and teeth, and may exert beneficial effects on the heart and bones. Although cod liver oil and fish oil are two very similar products, cod liver oil is richer in vitamins A and D.<\/p>\n

According to the European Pharmacopoeia (Ph. Eur. 7), Cod Liver Oil (Type A and Type B) is obtained from the fresh livers of wild Gadus morhua and other Gadidae species. Cod liver oil is a clear, yellowish liquid. It is practically insoluble in water, slightly soluble in alcohol, and miscible with petroleum ether. It should be stored in well-filled, airtight containers. When an antioxidant is not added, it should be stored under an inert gas. It must be protected from light.<\/p>\n

Zinkoksid- Zinci oxide- Oxyde de zinc<\/strong>– Zinkoxid [ASK; Ph. Eur.]- Blanc de zinc;<\/strong><\/p>\n

Zinc oxide is a white or yellowish-white, odorless, amorphous, soft, non-gritty powder. It slowly absorbs carbon dioxide from the air. It is practically insoluble in water and soluble in dilute mineral acids. Zinc oxide is a mild astringent with weak antiseptic properties. It is used topically to provide protection against sun rays. In such preparations used for photoprotection, it is often combined with titanium dioxide. In addition, it is applied topically in cases of eczema, abrasions, burns, friction-induced skin damage, diaper rash in infants, and mild skin irritations. Since it does not dissolve in water, it is applied in the form of powder, ointment, or paste. Zinc oxide ointment contains 20% and zinc oxide paste contains 25% zinc oxide. Calamine is a skin antiseptic containing 98% zinc oxide. Zinc oxide is also used in combination with coal tar or ichthammol in the treatment of eczema. Zinc oxide is not absorbed through the skin.<\/p>\n

Al\u00fcminyum silikat dihidrat- Caol\u00edn- Bolus alba- Kaolinite;<\/strong><\/p>\n

Kaolin is hydrated aluminum silicate. Light kaolin and natural light kaolin are used as adsorbents to assist rehydration therapy administered in controlling diarrhea. Against diarrhea, kaolin is often combined with another antidiarrheal agent such as pectin. Kaolin also has a demulcent effect. It is used topically as a dusting powder. Since it is extremely prone to bacterial contamination, kaolin intended for use as a dusting powder must definitely be sterilized. Light kaolin is also used as an additive in foods. Heavy kaolin is utilized in the preparation of kaolin poultice formulated for topical use against inflammation and pain.<\/p>\n

Kaolin is hydrated aluminum silicate. Heavy kaolin (Heavy Kaolin BP 1993, Ph. Eur.) constitutes a purified natural form of varying composition. It is a fine, white or grayish-white, unctuous powder. It is practically insoluble in water and organic solvents. According to the British Pharmacopoeia (BP), Light Kaolin (Light Kaolin BP 1993) is natural kaolin freed from most of its impurities by elutriation. It may contain a suitable dispersing agent. It is a light, white, odorless or almost odorless, unctuous, non-gritty powder. It is practically insoluble in water and mineral acids. According to the BP, Natural Light Kaolin (Light Kaolin, Natural, BP 1993) is light kaolin without any dispersing agent. According to the United States Pharmacopeia (USP), Kaolin (Kaolin USP 23) is a natural, purified, non-gritty kaolin freed from impurities. It occurs as a soft, white or yellowish-white powder or lumps with an earthy or clay-like odor; when moistened with water, its color darkens and its clay-like odor becomes pronounced. It is practically insoluble in water, cold dilute acids, or alkali hydroxide solutions.<\/p>\n

Lanoline- Graisse de laine- Adeps lanae- Rafine y\u00fcn ya\u011f\u0131- Lanae cera- Lanoleine T.K.;<\/strong><\/p>\n

It is obtained from sheep’s wool. It is light yellow in color and has an ointment consistency. It is soluble in ether, petroleum ether, chloroform, and boiling absolute alcohol. It is an emulsifier and forms water\/oil emulsions. In anhydrous form, its consistency is quite firm. Upon the addition of water, a dough-like mass is formed. It is easily absorbed by the skin and is odorless. It is used as an ointment base. The base recognized under the name lanolinum in the Turkish Pharmacopoeia (T.K.) contains 13 parts lanolin, 3 parts liquid paraffin, and 4 parts water. It is widely used in topical pharmaceutical formulations and cosmetic products. When blended with suitable vegetable oils or petrolatum, emollient creams that penetrate the skin are obtained. Due to this property, it facilitates the absorption of active ingredients. Lanolin mixes with approximately twice its weight of water without phase separation, producing stable emulsions.<\/p>\n

Solutio caclii hydroxidi;        <\/strong><\/p>\n

Calcium hydroxide, traditionally called slaked lime, is an inorganic compound with the chemical formula Ca(OH)2. It is a colorless crystal or white powder and is obtained when calcium oxide (called lime or quicklime) is slaked with water. It has many names such as hydrated lime, caustic lime, builders’ lime, slack lime, cal, or pickling lime. Calcium hydroxide is used in many applications, including food preparation. Limewater is the common name for a saturated aqueous solution of calcium hydroxide.<\/p>\n

Lime water is used externally in the treatment of burns. Properties: Lime water is an odorless, clear, colorless alkaline liquid with a bitter taste. Lime water absorbs carbon dioxide from the air, readily forming insoluble calcium carbonate.<\/p>\n

Incompatibilities: Lime water is incompatible with acids, carbonates, or water of standard hardness.<\/p>\n

Action and Indications: Lime water is an antacid and astringent. It is administered in small doses to relieve nausea and vomiting. It is also used in the treatment of diarrhea. Lime water is used externally in the treatment of burns.<\/p>\n

(USP) Lime water;<\/p>\n

CALCIUM HYDROXIDE     3 G<\/p>\n

PURIFIED WATER            1000 ML<\/p>\n

LIME WATER-EAU DE CHAUX-AQUA CALCARIAE T.K.(1954)<\/strong><\/p>\n

Contains 0.15-0.17 percent calcium hydroxide (Ca(OH)2).<\/p>\n

PREPARATION<\/strong>: 1 part quicklime is slaked with 4 parts water. The resulting yogurt-like mass is mixed and shaken with 50 parts water in a well-closed vessel. After the mixture settles, the supernatant aqueous liquid is discarded, and the mass remaining at the bottom of the vessel is vigorously shaken again with 50 parts water for five minutes and left to stand. When needed for use, it is drawn off by filtration.<\/p>\n

Preparation of the Formula:<\/strong><\/p>\n

The calculated amounts of zinc oxide and kaolin are triturated and blended in a mortar. A paste is formed by adding lanolin softened in a warm water bath, and after adding lime water, the fish oil is incorporated in small portions with continuous stirring to complete the preparation.<\/p>\n

Wishing you a good week\u2026<\/p>\n

References:<\/p>\n

1-Formularium der Nederlandse Apothekers 2009<\/p>\n

2-RxMediaPharma\u00ae2016 Interactive Drug Information Resource.<\/p>\n

Specialist Pharmacist Ahmet Nezihi Pekcan
\nPekcan Pharmacy – Konya
\npekcanecz@gmail.com<\/p>\n

Tel: (332) 3520657<\/p>\n

http:\/\/www.majistralformul.com\/<\/a><\/em><\/p>\n

 <\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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