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Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

Preparation of Monselís solution

  


Monselís solution is an excellent haemostatic and can be used to stop bleeding after taking punch biopsies. The solution can be used to prevent oozing of blood from the raw area left behind after performing the LLETZ procedure or even to stop a secondary haemorrhage encountered a few days after ablative or excisional treatment. The supply of Monselís solution is very limited in most low- and middle-income countries. It is possible to prepare the paste in a clinic or a laboratory, provided the ingredients are available.




Ingredients required:

  • Ferric sulfate base: 15 g
  • Ferrous sulfate powder: a few grains or a pinch of powder
  • Sterile water: 10 mL
  • Glycerol starch (see preparation below): 12 g

Apparatus and consumables required:

  • Glass beaker
  • Glass stirrer
  • Electronic top-loading balance
  • Laboratory apron
  • Brown-coloured glass bottle

Preparation:

  • Take 10 mL of sterile water in a glass beaker.
  • Add a few grains or a pinch of ferrous sulfate powder to the water. Stir well.
  • Add ferric sulfate powder to the prepared solution, and dissolve it completely by stirring with the glass stirrer.
  • Slowly add the prepared glycerol starch to the mixture, constantly stirring to obtain a homogeneous mixture.
  • Cover the beaker and let it stand for 48 hours.*
  • Store the mixture in a brown-coloured bottle with the cap sealed tightly.
* For clinical use, a sticky paste-like consistency works best. To obtain the desired consistency, the mixture can be kept uncovered to allow evaporation. This may take 2Ė3 weeks, depending on the environment.

Storage: 6 months

Label:

  • Monselís solution
  • For external use only
  • Shake well
  • Use by dd/mm/yyyy

Notes:

  • Shake the bottle or stir the solution well before applying.
  • If the solution becomes too thick in consistency over a period of time, add sterile water to thin it.
















Preparation of glycerol starch:


Ingredients required:

  • Starch powder: 30 g
  • Sterile water: 30 mL
  • Glycerine: 390 g

Apparatus and consumables required:

  • Conical flask
  • Glass stirrer
  • Electronic top-loading balance
  • Heating appliance or Bunsen burner
  • Laboratory apron

Preparation:

  • Pour the sterile water into a conical flask.
  • Add the measured quantity of starch powder to the water, and mix with the glass stirrer until it dissolves.
  • Add the glycerine to the solution, and mix well by stirring.
  • Heat the contents while stirring continuously.
  • Stop heating when the mixture is clear and transparent.
  • Cool the mixture, and store the prepared glycerol starch in a refrigerator.

Storage: 1 year

Label:

  • Glycerol starch
  • Store in a cool place
  • For external use only
  • Use by dd/mm/yyyy


Notes:

  • Use a large flask for preparation of glycerol starch, to prevent overflow and spillage during heating.
  • Stop heating the glycerol starch the moment it becomes clear and transparent. If overheating occurs, the mixture will have a yellow tinge and should be avoided.



































  


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