CTO DUO
Cervicothoracic zone concept, developed for the transition between neck and upper back.
Formulated for the cervicothoracic junction, a region of dense peripheral innervation and frequent clinical attention.
Label QR
Opens the public information page in the reader's language.
https://www.siriamlab.com/qr/cto-duo
Open patient pageComplete scientific monograph: anatomy, formulation architecture, references and revision record.
Chapter 01
Product identity
Identification, classification, family, intended use, anatomical region and the documents this record is governed by.
Identification of the record: product identifier, classification, family, intended use, anatomical region and the controlled documents it is governed by.
Documentation metadata+
Chapter 01 — related anatomy
Related documents
Future references
- GTIN / label identifierReservedCommercial identifier reserved for the published label.
Record identification
- Product ID
- SIR-CTO-01
- Family
- CTO DUO
- Region
- Cervical — cervicothoracic junction
- Last update
- 2026-01
Handbook source
Neurovascular and afferent modulation of the cervicothoracic transition (C8–T4), EMG targeted.
- Phase 1: activation and circulation
- Phase 2: stabilisation and integration
- Developer
- MT DO, DCP
- Pharmacist
- AVA
- Chapter version
- 1.0
- Product ID
- SIR-CTO-01
The handbook is the scientific master. Every statement rendered on this record originates from this chapter; the platform never creates independent scientific content.
Chapter 02
Executive summary
The record in short: professional summary, patient summary and the sequential treatment model behind it.
The record read in short: professional summary, patient summary and the sequential treatment model behind the formulation.
Documentation metadata+
Chapter 02 — related anatomy
Declared; content in preparation.
Related documents
Future references
- TranslationsReservedExecutive summary in Dutch, French and German.
Executive summary
The reading entry of the record: what the composition is for, in professional and in patient language.
Purpose
CTO DUO addresses the cervicothoracic transition as a single continuous surface field rather than as two separate areas.
Clinical goal
Primary anatomical region
neck
Primary therapeutic objective
Documented cutaneous topical composition for the cervicothoracic transition field.
Professional summary
CTO DUO is documented as a cutaneous topical composition for the neck application field. This summary is maintained by the documentation team and updated with each revision of the record.
Patient summary
Cervicothoracic zone concept, developed for the transition between neck and upper back.
Keywords
Chapter 03
Anatomy snapshot
The anatomical region of the record and every structure of its application field, resolving into the Neuro Atlas.
The anatomical identity of the record: the region, the segmental levels and the surface territory the formulation is documented for.
Documentation metadata+
Chapter 03 — related anatomy
Related documents
Future references
- 3D Atlas referenceReservedVolumetric reference of the field, prepared for the atlas engine.
- EMG referenceReservedFunctional EMG dataset linked to the segmental levels of this record.
- SRST referenceReservedSegmental reflex surface topography mapping.
Snapshot
Anatomy snapshot
Six metameric expressions per segment — dermatome, myotome, sclerotome, viscerotome, micro-angiotome and neurotome. Individual structures inside an expression open their own illustration plate.
Anatomy
Anatomical overview
The application field of CTO DUO is described through its dermatomes, peripheral nerves, plexus relations and metameric levels. Each object below resolves to the corresponding structure in the Neuro Atlas.
Segmental
Dermatomes
Segmental
Peripheral nerves
- Supraclavicular nervesLower neck, clavicular line and upper pectoral surface.Peripheral nerveAtlas →
- Dorsal scapular nerveMedial scapular border field.Peripheral nerveAtlas →
- Medial branches of the dorsal ramiParaspinal surface strips immediately lateral to the spinous processes.Peripheral nerveAtlas →
Segmental
Plexus relations
Segmental
Metamers
Professional mode
Segmental links are protected.
Metameric cross-references are reserved for practitioners trained in segmental reasoning. Enter your professional code to continue.
Segmental
Neurocutaneous regions
Anatomical identity
Primary region
Dermatomes
Peripheral nerves
Plexus
Metamers
Neurocutaneous territories
Body regions
Surface anatomy
- 3D Atlas referenceReservedVolumetric field reference.
- EMG referenceReservedFunctional EMG dataset.
- SRST referenceReservedSegmental reflex surface topography.
Chapter 04
Clinical purpose
Objective, strategy, workflow and the boundaries within which this record is documented.
The clinical objective of the record, its rationale, and the boundaries within which it is documented.
Documentation metadata+
Chapter 04 — related anatomy
Related documents
Future references
- Evidence levelReservedGraded evidence classification per documented statement.
- Clinical casesReservedStructured practitioner observations linked to this record.
Purpose
Why this formulation exists
CTO DUO is documented as a cutaneous topical composition for the neck application field. This summary is maintained by the documentation team and updated with each revision of the record.
Why this record exists
CTO DUO addresses the cervicothoracic transition as a single continuous surface field rather than as two separate areas.
Neurocutaneous region it was designed for
Cervicothoracic neurocutaneous zone
Anatomical interface it addresses
Cervical and cervicothoracic transition, including the supraclavicular field of the brachial plexus.
Clinical philosophy
At the cervicothoracic junction, supraclavicular branches of the cervical plexus meet the upper thoracic segmental bands and the medial branches of the dorsal rami, producing one of the densest superficial innervation patterns of the trunk.
- Cutaneous topical composition; the application field is defined by the treating professional.
- Application is documented per session so routines remain comparable over time.
Chapter 05
Application protocol
Timeline, application sites, professional and patient instructions, safety and storage.
Phases, cadence, duration, zone order and the documented application sequence, with practitioner and patient notes.
Documentation metadata+
Chapter 05 — related anatomy
Related documents
Future references
- Printable protocolReservedPrint-ready protocol sheet generated from this record.
Surface
Application zones
The zones listed are possible application locations. The practitioner identifies the exact spot within these possibilities using the SRST (Segmental Reflex Sensitisation Test). Future evaluation will use EMG before and after application.
Cervicothoracic junction
Detailed application guidance is in preparation.
Application fieldUpper trapezius field
Detailed application guidance is in preparation.
Application fieldInterscapular border
Detailed application guidance is in preparation.
Application field
Protocol
Application protocol
Phase 1
Release
Week 1–2 · 1–2 applications per day
Until phase 2 is introduced
The first texture is applied thinly on the target zone within the possible application zones, following the documented zone order.
Cervicothoracic junctionUpper trapezius fieldInterscapular borderPhase 2
Integration
Week 3 evening · from week 4 morning and evening
Until the product is finished
From week 3 phase 2 is added in the evening: phase 1 in the morning on the target zone, phase 2 in the evening on that same target zone. From week 4 — or once phase 1 is finished and phase 2 is recommended by the therapist — phase 2 is applied morning and evening on the target zone until the product is finished.
Cervicothoracic junctionUpper trapezius fieldInterscapular borderMaintenance
Continued routine
1–3 sessions per week
Ongoing, reviewed periodically
The routine is continued at a reduced cadence and reviewed with the practitioner at agreed intervals. Observations stay in the professional log so successive periods remain comparable.
Cervicothoracic junctionUpper trapezius fieldInterscapular border
Zone sequence
- 01Cervicothoracic junction
- 02Upper trapezius field
- 03Interscapular border
- 01Apply step one along the trapezius ridge toward the interscapular border.
- 02Allow the first layer to settle.
- 03Apply step two across the same field.
Landmarks
C7 spinous process and the acromion define the field.
Coverage
Even, thin coverage from midline to the scapular border.
Review
Reviewed with the practitioner at agreed intervals.
CTO protocol (definitive)
Zones
- Subclavicular left / right
- Sternum (T2–T4)
- Parascapular dorsal
Week 1–2
CTO-1 (1–2× per day)
Week 3
Morning: CTO-2 · Evening: CTO-1
Week 4
CTO-2 (1–2× per day)
Week 5
CTO-2 (evening)
On relapse: CTO-1 for 3 days.
Chapter 06
Formulation science
The scientific philosophy of the composition: sequential formulation, phase relationship and ingredient rationale.
The composition read as an architecture, with the current formula held read-only and any proposed successor documented alongside it.
Documentation metadata+
Chapter 06 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Ingredient linksReservedEvery constituent resolving to its RM-001 entry.
- Version comparisonReservedSide-by-side comparison of current and proposed composition.
Composition
Formulation architecture
The composition is documented as a map rather than a list. Every constituent is recorded with the function it carries, the reason it is present in this field, how it relates to the rest of the composition and the cutaneous topical formulation category it belongs to.
- 01Aqua base
Aqua
Carrier system
- Functional role
- Carrier phase
- Formulation purpose
- Sets the water phase that determines spreadability across a defined surface field.
- Interaction within the composition
- Holds the humectant fraction in solution and carries the emulsified lipid phase evenly over the zone.
- 02Glycerin
Glycerin
Humectant
- Functional role
- Moisture binding
- Formulation purpose
- Keeps the applied layer supple so the same field can be worked repeatedly without dryness on the skin surface.
- Interaction within the composition
- Balances the emollient fraction: the humectant governs the water phase, the emollient the lipid phase.
- 03Shea butter
Butyrospermum parkii butter
Emollient
- Functional role
- Skin-feel and occlusive body
- Formulation purpose
- Gives the texture enough body to stay on the applied zone rather than running along the hairline.
- Interaction within the composition
- Carries the lipid-soluble antioxidant fraction and slows the evaporation of the water phase.
- 04Panthenol
Panthenol
Conditioning agent
- Functional role
- Surface conditioning
- Formulation purpose
- Documented as a conditioning constituent of the cutaneous topical base; contributes to a smooth, non-tacky finish.
- Interaction within the composition
- Water-soluble; works alongside glycerin in the same phase without altering the emulsion.
- 05Tocopherol
Tocopherol
Antioxidant stabiliser
- Functional role
- Formulation stability
- Formulation purpose
- Protects the lipid fraction over the shelf life of the record so successive batches stay comparable.
- Interaction within the composition
- Dissolved in the shea fraction; stabilises the constituents it is dispersed in rather than acting on the skin.
Reading the map
Constituents are grouped by formulation category: a carrier system that governs spread, a water phase that governs feel, a lipid phase that governs stay-time, and stabilising constituents that keep successive batches comparable. Interactions describe the composition only; no physiological effect is asserted.
Cutaneous topical formulation rationale
The formulation is built for reproducible application on the documented zones: a texture that spreads thinly, a controlled sensory profile and a composition suitable for repeated professional use.
Representative composition overview. The full INCI listing is published in the composition index.
Philosophy
Formulation philosophy
Formulation philosophy: composition is selected for a defined surface field and a reproducible application sequence. The record documents composition and application only; no physiological or therapeutic mechanism is claimed.
At the cervicothoracic junction, supraclavicular branches of the cervical plexus meet the upper thoracic segmental bands and the medial branches of the dorsal rami, producing one of the densest superficial innervation patterns of the trunk.
Chapter 07
Product formula
Linked document PF-001. The formulation master: phase formulas, ingredient records, suppliers and the current → proposed comparison.
Linked document PF — the formulation master. Ingredient data exists once, in the product formula record, and is referenced from here.
Documentation metadata+
Chapter 07 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Ingredient linksReservedEvery constituent resolving to its RM-001 entry.
- Version comparisonReservedSide-by-side comparison of current and proposed composition.
CTO DUO — Product Formula record
- Document
- PF-004
- Version
- 1.0
- Revision date
- 2026-08
- Basis
- Lanette protocol, two sequential phases of 100 g.
Phase 1 — Flow activation
- Intent
- Activation and circulation.
- Batch size
- 100 g
- Filling
- —
Ingredient table — as approved in the handbook
| Ingredient | Source | Quantity | Remark |
|---|---|---|---|
| Lanette cream FNA | — | 65 g | — |
| Aqua purificata | — | 18 g | — |
| Magnesium chloride | — | 3 g | — |
| MSM | — | 2.5 g | — |
| D-Panthenol | — | 0.5 g | — |
| Vitamin E | DIY | 0.4 g | — |
| Ginkgo biloba | Matisson | 1.2 g | — |
| Rhodiola rosea extract | — | 0.2 g | — |
| Niacinamide | — | 1.2 g | — |
| Boswellia | WeightWorld | 0.8 g | — |
| Copaiba | — | 0.25 g | — |
| Silicea Gel | — | 2.5 g | Belongs to the water phase. |
| Betaine TMG | — | 0.5 g | — |
Phase 2 — Flow stabilisation
- Intent
- Stabilisation and integration.
- Batch size
- 100 g
- Filling
- —
Ingredient table — as approved in the handbook
| Ingredient | Source | Quantity | Remark |
|---|---|---|---|
| Lanette cream FNA | — | 67 g | — |
| Aqua purificata | — | 16 g | — |
| Magnesium chloride | — | 2 g | — |
| MSM | — | 1.2 g | — |
| D-Panthenol | — | 1 g | — |
| Vitamin E | NH | 0.7 g | — |
| Ginkgo biloba | Matisson | 0.6 g | — |
| Niacinamide | — | 1.5 g | — |
| Boswellia | WeightWorld | 1 g | Two softgels. |
| Copaiba | — | 0.4 g | — |
| Blue Lotus | — | 0.15 g | — |
| Bacopa monnieri | — | 0.5 g | — |
| Silicea Gel | — | 3 g | Belongs to the water phase. |
| Betaine TMG | — | 0.8 g | — |
Ingredient cards — CTO-1
Lanette cream FNA
65 g
Source
Not declared in the handbook
Aqua purificata
18 g
Source
Not declared in the handbook
Magnesium chloride
3 g
Source
Not declared in the handbook
MSM
2.5 g
Source
Not declared in the handbook
D-Panthenol
0.5 g
Source
Not declared in the handbook
Vitamin E
0.4 g
Source
DIY
Ginkgo biloba
1.2 g
Source
Matisson
Rhodiola rosea extract
0.2 g
Source
Not declared in the handbook
Niacinamide
1.2 g
Source
Not declared in the handbook
Boswellia
0.8 g
Source
WeightWorld
Copaiba
0.25 g
Source
Not declared in the handbook
Silicea Gel
2.5 g
Source
Not declared in the handbook
Belongs to the water phase.
Betaine TMG
0.5 g
Source
Not declared in the handbook
Ingredient cards — CTO-2
Lanette cream FNA
67 g
Source
Not declared in the handbook
Aqua purificata
16 g
Source
Not declared in the handbook
Magnesium chloride
2 g
Source
Not declared in the handbook
MSM
1.2 g
Source
Not declared in the handbook
D-Panthenol
1 g
Source
Not declared in the handbook
Vitamin E
0.7 g
Source
NH
Ginkgo biloba
0.6 g
Source
Matisson
Niacinamide
1.5 g
Source
Not declared in the handbook
Boswellia
1 g
Source
WeightWorld
Two softgels.
Copaiba
0.4 g
Source
Not declared in the handbook
Blue Lotus
0.15 g
Source
Not declared in the handbook
Bacopa monnieri
0.5 g
Source
Not declared in the handbook
Silicea Gel
3 g
Source
Not declared in the handbook
Belongs to the water phase.
Betaine TMG
0.8 g
Source
Not declared in the handbook
Supplier links
Sources named in the handbook. Qualification and specifications are held in the approved raw-material manual; this record shows the relationship only.
- DIY
- Matisson
- WeightWorld
- NH
Current → proposed
| Field | Current | Proposed |
|---|---|---|
| Formula version | PF-004 v1.0 — approved | Reserved — no successor issued |
| Ingredient table | Phase 1 and phase 2 as approved in HB-CTO | Reserved — change request required (RM-008) |
Chapter 08
Standard operating procedure
Linked document SOP-001. The manufacturing master: workflow, equipment, quality control, packaging, traceability and release criteria.
Linked document SOP — the manufacturing master. Process, equipment, quality control, packaging and traceability.
Documentation metadata+
Chapter 08 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Batch recordsReservedExecuted batch documentation linked to each manufactured lot.
- Deviation managementReservedRegistered deviations and corrective actions.
CTO DUO — manufacturing record (Lanette protocol)
- Document
- SOP-004
- Version
- 1.0
- Revision date
- 2026-08
Manufacturing timeline
- 01Weigh Lanette cream FNA and aqua purificata separately and heat both to ±60 °C under gentle stirring.
- 02Dissolve magnesium chloride, MSM, niacinamide and betaine TMG completely in the water phase until clear.
- 03Separately mix vitamin E, Boswellia and Copaiba with a small amount of jojoba oil into a smooth lipophilic dispersion.
- 04Add the warm water phase slowly to the Lanette base under continuous homogeneous stirring, without incorporating air.
- 05Add the lipophilic mix to the emulsion at ±45 °C and homogenise gently until fully distributed.
- 06Add Ginkgo biloba and Rhodiola rosea (phase 1) or Blue Lotus (phase 2) gradually under calm stirring.
- 07Let the emulsion cool below 40 °C before adding D-panthenol and other temperature-sensitive components.
- 08Below 35 °C, add Bacopa monnieri (phase 2), Silicea gel and any homeopathic components and homogenise briefly.
- 09Check pH (target 5.2–5.5), viscosity and homogeneity without overmixing.
- 10Fill at ±30 °C into 15 ml airless dispensers and stabilise for 24–48 hours before use.
Quality control
- pH range
- 5.2 – 5.5
- Process temperature
- ±60 °C base and water phase
- Lipophilic addition
- ±45 °C
- Sensitive additions
- Below 35 °C
- Filling temperature
- ±30 °C
- Stabilisation
- 24 – 48 hours before use
Critical checklist
- ✔MSM completely dissolved — otherwise noise in the effect.
- ✔Magnesium well distributed — essential for metameric action.
- ✔No phase separation.
- ✔No air bubbles — they affect dosing.
- ✔Correct viscosity (airless compatible).
Equipment
- Balance for separate weighing of base and water phase
- Heating bath / plate to ±60 °C
- Stirring equipment for continuous homogeneous mixing without air inclusion
- Homogeniser
- pH measurement
- 15 ml airless dispensers for filling
Batch structure
- Phase 1 batch
- 100 g
- Phase 2 batch
- 100 g
- Filling
- 15 ml airless dispensers
Release criteria
- pH within 5.2 – 5.5.
- Homogeneous emulsion without phase separation.
- No air bubbles in the filled dispenser.
- Viscosity compatible with airless dispensers.
- Stabilised 24 – 48 hours before release.
Traceability
- Developer
- MT DO, DCP
- Pharmacist
- AVA
- Manufacturing records
- RM-005 — relationship only
- Quality assurance
- RM-006 — relationship only
Chapter 09
Reference manuals
RM-001 → RM-010. The quality management library this record is connected to, referenced by relationship only.
The reference manual library RM-001 → RM-010, connected to this record by relationship only.
Documentation metadata+
Chapter 09 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Manual publicationReservedReference manuals published as controlled documents.
Documentation hub — reference manuals
RM-001
Ingredient library
Single source for every constituent used in a formulation.
RM-002
Formula matrix
Composition matrix across families and versions.
RM-003
Approved materials
Qualified raw materials and their specifications.
RM-004
Inventory
Material positions, lots and expiry tracking.
RM-005
Manufacturing
Process documentation and manufacturing instructions.
RM-006
Quality assurance
Release checks, deviations and corrective actions.
RM-007
Equipment
Equipment identity, qualification and maintenance.
RM-008
Change control
Governance of proposed versions and their approval.
Reference manual integration
- RM-001Ingredient librarySingle source for every constituent used in a formulation.
- RM-002Formula matrixComposition matrix across families and versions.
- RM-003Approved materialsQualified raw materials and their specifications.
- RM-004InventoryMaterial positions, lots and expiry tracking.
- RM-005ManufacturingProcess documentation and manufacturing instructions.
- RM-006Quality assuranceRelease checks, deviations and corrective actions.
- RM-007EquipmentEquipment identity, qualification and maintenance.
- RM-008Change controlGovernance of proposed versions and their approval.
- RM-009StabilityStability programme and observation intervals.
- RM-010Clinical outcomesStructured observation framework for practitioners.
Chapter 10
QR patient information
The label surface, generated from the digital record: what the formulation is, its timeline, application areas, safety and quality assurance.
The label surface of the record, generated from the digital record so patient information can never drift from the documentation.
Documentation metadata+
Chapter 10 — related anatomy
Related documents
Future references
- Printed QRReservedProduction-ready QR code bound to the published version.
Documentation
Downloads
Label
QR resources
Each package carries a QR code that resolves to this documentation record in the reader's language, together with the composition index and the current application protocol. Codes are versioned, so updated documentation reaches practitioners without relabelling.
Resolves to /products/cto-duo
QR information
- Current QR resolves to
- /products/cto-duo
- Current version
- 1.4
- Last update
- 2026-01
- Batch number
- CTO-2601
Storage information
Store closed, upright and away from direct sunlight. Storage conditions are documented on the label and repeated here without alteration.
Professional information
Professional reading opens the complete monograph: anatomy, composition architecture, protocol and revision record.
Patient information
Essential reading describes what the composition is, where it is applied and in which order, without clinical interpretation.
- Multilingual QR contentReservedReserved: Dutch, English, French and German resolution of the same record.
Chapter 11
Professional documentation
The controlled document set of this record: references, questions, governance and search metadata.
The document hub of the record. Each document exists once in the controlled set and is referenced from here.
Documentation metadata+
Chapter 11 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Digital signatureReservedSigned approval attached to the published version.
Education
Educational references
- Surface field mapping — method noteLandmark-based definition of application fields.SIRIAM LAB, internal documentation
- Segmental innervation referenceDermatome, nerve and metamer objects used by this record.SIRIAM LAB Neuro Atlas dataset
FAQ
Frequently asked questions
Is this a medicinal product?
No. SIRIAM formulations are cutaneous topical compositions. They are described by application region and composition, not directed at a therapeutic indication but rather at regulation of the nervous system. EMG validation will need to support this further in the future.
Who determines the application region?
The region is identified by a healthcare professional using anatomical landmarks and surface maps. Our documentation supports that conversation.
Can the formulation be combined with other routines?
Combination and sequencing are decided together with the treating professional. We document composition, application and response.
Document hub
Product formula card
Reference manuals
Standard operating procedures
Publications
Handbook placement
- Chapter
- CTO DUO record
- Subchapter
- Anatomy, purpose, protocol, composition, documentation
Scientific sections
Citations
- CitationsReservedFormal citation of this record inside handbook chapters.
Document hierarchy
- HB-CTOHandbook chapter — scientific master
- SDR-001Digital record — presentation source
- PF-004Product formula — formulation master
- INGIngredient cards — derived from the formula
- SUPSupplier links — RM-003 relationship
- SOP-004Manufacturing record
- RMReference manuals — relationships only
- ATLASNeuro Atlas — anatomical relationships
- RESEARCHResearch modules
- QRQR record — patient presentation
Every document carries its own version. Revising the formula does not modify the digital record; revising the manufacturing record does not modify the formula.
Governance of this record
- Responsible author
- SIRIAM LAB documentation team
- Scientific reviewer
- Scientific review board
- Approval status
- Approved
- Release date
- 2026
- Revision date
- 2026-01
- Digital signature
- Reserved
Record metadata
Region
Dermatomes
Peripheral nerves
Plexus
Metamers
Clinical goal
Ingredients
Therapeutic category
Product family
Current version
Documentation
Research
SDR header — product identity
The identification block of the record. Every renderer reads these fields; none of them is restated elsewhere.
Product name
CTO DUO
Product code
CTO
Product family
DUO
Product category
Cutaneous topical composition
Current formula version
1.4
Documentation version
1.0
QR version
1.4
Scientific status
Established
Documentation status
Documented
Clinical status
Documented — cutaneous topical composition, no therapeutic claim
Approval status
Approved
Last revision
2026-01
Responsible institute
SIRIAM LAB — European institute for neurodermal science
Responsible author
SIRIAM LAB documentation team
Scientific reviewer
Scientific review board
Current language
English (EN)
Additional languages
Product identifier
SIR-CTO-01
Executive summary
The reading entry of the record: what the composition is for, in professional and in patient language.
Purpose
CTO DUO addresses the cervicothoracic transition as a single continuous surface field rather than as two separate areas.
Clinical goal
Primary anatomical region
neck
Primary therapeutic objective
Documented cutaneous topical composition for the cervicothoracic transition field.
Professional summary
CTO DUO is documented as a cutaneous topical composition for the neck application field. This summary is maintained by the documentation team and updated with each revision of the record.
Patient summary
Cervicothoracic zone concept, developed for the transition between neck and upper back.
Keywords
Anatomical record
Anatomy is held once in the Neuro Atlas. This section declares which atlas objects the record belongs to.
Primary region
neck
Body region
neck
Dermatomes
Peripheral nerves
Plexus
Metameres
Neurocutaneous territories
Embryological layer
Related regions
Future EMG mapping
Future SRST mapping
Future atlas reference
Clinical record
The documented boundaries of the record. Statements are descriptive; no therapeutic effect is claimed.
Clinical objective
CTO DUO addresses the cervicothoracic transition as a single continuous surface field rather than as two separate areas.
Primary indications
Secondary indications
Contraindications
Not applied to broken, irritated or recently treated skin, nor to the eye region. Documented per session by the treating professional.
Warnings
Cutaneous topical composition. Information is provided for education and professional reference; it is not medical advice and implies no therapeutic effect.
Expected response
Sensory and cutaneous topical observations only, recorded in the professional log so successive periods remain comparable.
Treatment phase
Evidence status
Professional notes
Patient notes
Application record
The reproducible application of the record: field, sequence, cadence and handling.
Application zone
Application method
Treatment frequency
Week 1–2 · 1–2 applications per day
Treatment duration
Until phase 2 is introduced
Maintenance
The routine is continued at a reduced cadence and reviewed with the practitioner at agreed intervals. Observations stay in the professional log so successive periods remain comparable.
Patient instructions
Professional instructions
Storage
Stored closed, upright and away from direct sunlight. Storage conditions are documented on the label and repeated here without alteration.
Shelf-life
Packaging
DUO presentation; batch CTO-2601.
Formulation record
The current formula is read-only. A proposed successor is held alongside it and never merged into it.
Formulation philosophy
Formulation philosophy: composition is selected for a defined surface field and a reproducible application sequence. The record documents composition and application only; no physiological or therapeutic mechanism is claimed.
Scientific rationale
At the cervicothoracic junction, supraclavicular branches of the cervical plexus meet the upper thoracic segmental bands and the medial branches of the dorsal rami, producing one of the densest superficial innervation patterns of the trunk.
Current formula
1.4 — Current approved composition.
Mechanism
Formulation philosophy: composition is selected for a defined surface field and a reproducible application sequence. The record documents composition and application only; no physiological or therapeutic mechanism is claimed.
Manufacturing notes
Quality notes
Current PF
PF-CTO-1.4
Current formula version
1.4
Future formula
Future change request
Ingredient table
| Constituent | Role | Purpose | Category |
|---|---|---|---|
| Aqua base | Carrier phase | Sets the water phase that determines spreadability across a defined surface field. | Carrier system |
| Glycerin | Moisture binding | Keeps the applied layer supple so the same field can be worked repeatedly without dryness on the skin surface. | Humectant |
| Shea butter | Skin-feel and occlusive body | Gives the texture enough body to stay on the applied zone rather than running along the hairline. | Emollient |
| Panthenol | Surface conditioning | Documented as a conditioning constituent of the cutaneous topical base; contributes to a smooth, non-tacky finish. | Conditioning agent |
| Tocopherol | Formulation stability | Protects the lipid fraction over the shelf life of the record so successive batches stay comparable. | Antioxidant stabiliser |
Documentation record
Each document exists once in the controlled set and is referenced from here; nothing is duplicated.
Product formula
PF-CTO-1.4
Reference manuals
Standard operating procedures
Appendices
Handbook chapters
Part IV — Formulation records · CTO DUO record
Downloads
Scientific references
QR information
/products/cto-duo
Version history
Connected knowledge
The record as a node of the knowledge network. Relationships are declared here and resolved by the graph.
Related products
Related anatomical structures
Related dermatomes
Related peripheral nerves
Related plexuses
Related ingredients
Related publications
Related research
Related RM
Related SOP
Future clinical cases
Future AI suggestions
QR record
The product page is the official destination of every QR code printed on the packaging.
QR status
Active
QR version
1.4
QR URL
/products/cto-duo
QR created
2026
QR last updated
2026-01
Current batch
CTO-2601
Current product version
1.4
Patient information
Essential reading describes what the composition is, where it is applied and in which order, without clinical interpretation.
Professional information
Professional reading opens the complete monograph: anatomy, composition architecture, protocol and revision record.
Version record
The current version is never overwritten. Every superseded version is archived and retained.
Current version
1.4
Previous version
None recorded
Next planned version
Revision date
2026-01
Change requests
Approval workflow
Current → proposed → scientific review → approval → publication → archive.
Archive
1 documented version retained.
Archive
| Version | Date | Change |
|---|---|---|
| 1.0 | 2026 | Initial documentation record published in the Product Library. |
Search metadata
The flat index of the record, prepared for platform search and future APIs.
Region
Dermatomes
Peripheral nerves
Plexus
Metamers
Clinical goal
Ingredients
Therapeutic category
Product family
Current version
Documentation
Research
Digital relationships
- PFProduct formula card PF-CTO-1.4In preparationOne formula card per version; referenced, never duplicated.
- RM-001Ingredient libraryReservedSingle source for every constituent used in a formulation.
- RM-002Formula matrixReservedComposition matrix across families and versions.
- RM-003Approved materialsReservedQualified raw materials and their specifications.
- RM-004InventoryReservedMaterial positions, lots and expiry tracking.
- RM-005ManufacturingReservedProcess documentation and manufacturing instructions.
- RM-006Quality assuranceReservedRelease checks, deviations and corrective actions.
- RM-007EquipmentReservedEquipment identity, qualification and maintenance.
- RM-008Change controlReservedGovernance of proposed versions and their approval.
- RM-009StabilityReservedStability programme and observation intervals.
- RM-010Clinical outcomesReservedStructured observation framework for practitioners.
- SOP-01Application documentationPublishedProcedure referenced by this record.
- SOP-02Record revision and approvalIn preparationProcedure referenced by this record.
- Appendix ATerminologyPublishedControlled appendix of the documentation set.
- Appendix BIdentifiers and codesPublishedControlled appendix of the documentation set.
- ATLASNeuro AtlasPublishedAnatomical objects of this record.
- HANDBOOKPart IV — Formulation recordsPublishedHandbook placement of this record.
- QRQR resourcePublishedOfficial destination of the printed QR code.
- PUBScientific publicationsReservedPublications citing this record.
Chapter 12
Knowledge graph
This record as a node of the knowledge network: products, anatomy, atlas structures, ingredients and documents.
This record as a node of the knowledge network: related products, anatomy, research, handbook parts and documents.
Documentation metadata+
Chapter 12 — related anatomy
Related documents
Future references
- AI suggestionsReservedAutomatically generated relationship proposals reviewed before publication.
- Clinical casesReservedCase records connected to this formulation.
Research
Related research modules
Chapter 13
Version history
Current version, previous versions, change requests, scientific review, approval, publication and archive.
Version control of the record: current version, previous versions, change requests, review, approval, publication and archive.
Documentation metadata+
Chapter 13 — related anatomy
Declared; content in preparation.
Related documents
Future references
- ArchiveReservedImmutable archive of superseded versions.
Record
Version history
- v1.0 · 2026Initial documentation record published in the Product Library.
Version record
The current version is never overwritten. Every superseded version is archived and retained.
Current version
1.4
Previous version
None recorded
Next planned version
Revision date
2026-01
Change requests
Approval workflow
Current → proposed → scientific review → approval → publication → archive.
Archive
1 documented version retained.
Archive
| Version | Date | Change |
|---|---|---|
| 1.0 | 2026 | Initial documentation record published in the Product Library. |
Version lifecycle
- 01Current versionApproved and published; read-only.Published
- 02Proposed versionHeld alongside the current version, never merged into it.In preparation
- 03Scientific reviewReview of the proposal against the reference manuals.Reserved
- 04ApprovalFormal approval by the scientific reviewer.Reserved
- 05PublicationThe approved version becomes the current version.Reserved
- 06ArchiveThe superseded version is retained for traceability.Reserved
The current version is never overwritten. A proposed version is held as a separate object; superseded versions are archived and retained.
Chapter 14
Appendices
Supplier list, ingredient classification, document coding, QR standard and glossary.
Supporting registers of the handbook: suppliers, ingredient classification, document coding, the QR standard and the glossary.
Documentation metadata+
Chapter 14 — related anatomy
Declared; content in preparation.
Related documents
Future references
- Supplier qualificationReservedQualification status per supplier, held in RM-003.
Appendix A — Supplier list
| Supplier | Referenced by |
|---|---|
| DIY | CTO-1 |
| Matisson | CTO-1 · CTO-2 |
| WeightWorld | CTO-1 · CTO-2 |
| NH | CTO-2 |
Appendix B — Ingredient classification
- Base
- Carrier phase determining spreadability and dermal contact time.
- Functional
- Constituent selected for the documented functional intent of the phase.
- Modulating
- Constituent adjusting tolerance, texture or release of the phase.
- Sensory
- Constituent determining the sensory signature of the application.
Appendix C — Document coding
- HB-…
- Handbook chapter — the scientific master.
- SDR-…
- SIRIAM digital record — the digital product record.
- PF-…
- Product formula — the formulation master.
- SOP-…
- Standard operating procedure — the manufacturing master.
- RM-…
- Reference manual — the quality management master.
Appendix D — QR standard
- Source
- Patient information is generated from the digital record; it is never written separately.
- Scope
- Product identity, treatment goal, timeline, application areas, safety and quality assurance.
- Binding
- Each published QR surface is bound to one approved record version.
Appendix E — Glossary
- Neurodermal
- The relationship between segmental innervation and the cutaneous surface.
- DUO
- A sequential formulation applied in two documented phases.
- Metamere
- The segmental unit linking dermatome, myotome, sclerotome and viscerotome.
- SRST
- Segmental reflex surface topography.
Quality system
Version control
The current composition and any proposed successor are documented side by side. Approval and change control are handled outside the platform.
Current formula
- Version
- 1.4
- Revision date
- 2026-01
Current approved composition.
Proposed formula
No successor is currently proposed for this record.
QR information
- QR target
- /products/cto-duo
- Batch reference
- CTO-2601
- Record status
- Documented
The QR code printed on the label resolves to this record. The product page is the single source of truth; printed material never carries content that is not documented here.
Controlled documents →Continue
Explore further
Cutaneous topical formulation. Information is provided for education and professional reference; it is not medical advice and implies no therapeutic effect.
Back to the ecosystem →Knowledge graph
Related knowledge
Everything connected to this formulation: anatomy, application zones, ingredients, protocols, research and documentation.
Formulation
Metamer
Peripheral nerve
Plexus
Neurocutaneous zone
Application zone
Knowledge article
Research
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