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Selenase® In Plastic Surgery

Scientific information On

Plastic Surgery

Causes Of Ischaemia:

  • Complete (no perfusion) unpredictable ischaemia, micro and macro amputations (fingers, arms, legs etc.)
  • Incomplete (some residual perfusion) unpredictable ischaemia, contusions, avulsions
  • Predictable ischaemia, free flaps (pedicled flaps, muscles, fascia, adipose tissue, intestine)
  • Special case: burns

Risks After Reperfusion:

  • Microthrombosis
  • Inflammation
  • Necrosis

Conventional Measures to Prevent SIRS:


  • restoration of patency


  • anticoagulants (heparin, NSAR), thrombolytic substances, anti-inflammatory drugs, free radical scavengers, vasodilators (Ca-channel inhibitors), immunomodulators


  • application of cold before reperfusion, heat treatment after completion of anastomoses

Data on Selenium (Selenite):

  • In animal models: Ebselen derfers arterial and prevents venous thrombus formation [Lindenblatt et al. Thromb Haemost 2003; 90: 882-892]
  • In clinical studies: selenite modulates pulmonary infection rates after major burns and leads to an increase in selenium under the skin [Berger et al. Am J Clin Nutr 2007; 85: 1293-1300.]

Possible Actions of Selenium/Selenase® Supplementation:

  • Prevention or minimisation of cell death after reperfusion
  • Conservation of the tissue / body part
  • Minimisation of “after burning” in burns

Suggested Timing And Dosage For Selenium Supplementation:

Time point Dosage
Pre-operative bolus 1000 g Se as selenase® solution for injection
Intra-operative 1000 g Se/24h as selenase® solution for injection
Post-operative 1000 – 500 g Se/d as selenase® solution for injection

Information sheet on PLASTIC SURGERY, biosyn Arzneimittel GmbH, RSi 2008. According to a lecture given by Prof Dr med H Homann, Thieme Workshop 2008 entitled “Ischaemia and reperfusion an interdisciplinary challenge”. For personal use only.

Abbreviated Prescribing Information

selenase® 100 micrograms, solution for injection (50 micrograms/ml) selenase® 500 micrograms, solution for injection (50 micrograms/ml)

  • Active ingredient: sodium selenite pentahydrate.
  • Composition: Each 2 ml ampoule/10 ml injection vial contains 100 micrograms/500 micrograms selenium as 333 micrograms/ 1.66mg sodium selenite pentahydrate (Na2SeO3 x 5H2O), corresponding to 50 micrograms/ml.
  • Excipients: Sodium chloride, hydrochloric acid, Water for Injections.
  • Indication: Proven selenium deficiency that cannot be offset from food sources.
  • Posology and Administration: selenase® solution for injection is administered as an intramuscular or intravenous injection at a daily dose of 100 ­ 200 g (1.27 ­ 2.53 mol) selenium. If necessary, this dose can be increased to 500 g (6.33 mol) for a typical adult. No dosage adjustment is required for paediatric, renal or hepatic impairment patients.
  • Contraindications: Selenosis.
  • Interactions: Ensure that the pH value does not fall below 7.0 and that the solution is not mixed with reducing substances (e.g. vitamin C).
  • Pregnancy and Lactation: There are no data from the use of selenase® in pregnant or lactating women.
  • Undesirable Effects: None known to date when used as directed.
  • Overdose: Counter measures include gastric lavage, forced diuresis, dialysis or administration of high doses of vitamin C.
  • Pharmaceutical Precautions: Store below 25ºC.
  • Legal Category: POM.
  • Presentation: Cartons containing 10 x 2ml ampoules / 10 x10ml glass vials for single use.
  • MA Numbers: PL 20437/0003, PL 20437/0004.
  • MA Holder: biosyn Arzneimittel GmbH, Schorndorfer Str 32, D-70734 Fellbach, Germany.
  • Date of Preparation: November 2004