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Appendix 3: Preparation of 5% acetic acid, Lugol's iodine solution, Monsel's paste, Glycerol starch

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5% dilute acetic acid Ingredients
1. Glacial acetic acid: 5 ml
2. Distilled water: 95 ml

Preparation
Carefully add 5 ml of glacial acetic acid into 95 ml of distilled water and mix thoroughly.

Storage
Unused acetic acid should be discarded at the end of the day.

Label
5% dilute acetic acid
Note: It is important to remember to dilute the glacial acetic acid, since the undiluted strength causes a severe chemical burn if applied to the epithelium.

Lugol's iodine solution Ingredients
1. Potassium iodide: 10 g
2. Distilled water: 100 ml
3. Iodine crystals: 5 g

Preparation
A. Dissolve 10 g potassium iodide in 100 ml of distilled water.
B. Slowly add 5 g iodine crystals, while shaking.
C. Filter and store in a tightly stoppered brown bottle.

Storage
1 month

Label
Lugol's iodine solution; Use by (date)

Monsel's paste Ingredients
1. Ferric sulfate base: 15 g
2. Ferrous sulfate powder a few grains
3. Sterile water for mixing: 10 ml
4. Glycerol starch (see preparation on next page): 12 g

Preparation
Take care: The reaction is exothermic (emits heat).

1. Add a few grains of ferrous sulfate powder to 10 ml of sterile water in a glass beaker. Shake.
2. Dissolve the ferric sulfate base in the solution by stirring with a glass stick. The solution should become crystal clear.
3. Weigh the glycerol starch in a glass mortar. Mix well.
4. Slowly add ferric sulfate solution to glycerol starch, constantly mixing to get a homogeneous mixture.
5. Place in a 25 ml brown glass bottle.
6. For clinical use, most clinics prefer to allow enough evaporation to give the solution a sticky pastelike consistency that looks like mustard. This may take 2 to 3 weeks, depending on the environment. The top of the container can then be secured for storage. If necessary, sterile water can be added to the paste to thin it.

Note: This preparation contains 15% elementary iron.

Storage
6 months

Label
Monsel's solution; Shake well; External use only; Use by (date)

Glycerol starch
(an ingredient in Monsel's paste) Ingredients
1. Starch: 30 g
2. Sterile water for mixing: 30 ml
3. Glycerine: 390 g

Preparation

1. In a china crucible, dissolve the starch in the sterile water.
2. Add the glycerine. Shake well.
3. Heat the crucible and its contents over a bunsen burner. Mix constantly with a spatula until the mass takes on a thick, swelling consistency. Take care not to overheat so as not to let it turn yellow.

Storage
1 year

Label
Glycerol starch
Store in a cool place
For external use only
Use by (date)
Note: Do not overheat, otherwise the mixture will turn yellow.