I would like advice on the following preparation: Sugar 500 g, PEG 400 250 g, Water dipped. 20 ml

The preparation does not make so many problems. The sugar is mixed with the small amount of water and then the PEG 400 can be added.

Comment (with advice from Apoth. B. Benraad, St Maartenskliniek, Nijmegen)
for the grain formation and consistency the sugar quality plays a role. But the commercially available powdered sugar (flour sugar) with a desiccant (starch) should be discouraged and granulated sugar should be used. After all, the absence of non-soluble particles (starch) is important so that no particles can be left in the wound. But also pulverized granulated sugar (powdered sugar) is usable!

grinding (eg in a coffee grinder) of granulated sugar before making a paste of it is not necessary for the effect. But if you make a paste with pulverized granulated sugar, you will get a nicer thin paste with a thicdiable consistency in the direction of sugar syrup. It has less large "chunks" and is easier for example to put in a fistula using a catheter syringe.

The thick paste can be made fine with granulated sugar but it is a paste, which should be applied with the spatula just like cement or chocolate paste. Nevertheless, the use of this thicker paste is easier than just sugar, which spreads too easily. After all, a number of Pati ë Nten (thoracic wounds) were treated with granulated sugar. Dirty smelly wounds are cleaned fine in this way but one finds sugar everywhere!