Newswise — Using a particular brand of medical honey dressing may be a safe, effective and low-cost method of treating chronic, non-healing wounds in indigent patients, according to a poster presented at the Symposium on Advanced Wound Care (SAWC) and the Wound Healing Society (WHS), an international conference drawing clinicians from all over the globe, which was held April 17-20 in Orlando.
Registered nurses Diane Maggio RN, BSN, CRRN, CWON and Laverne Graves, RN, BSN, CWS, from the AtlantiCare Regional Medical Center in Pomona, NJ identified several challenges when treating indigent patients at the outpatient wound clinic. They include poor patient compliance, multiple wound types, lack of finances, multiple health issues, and poor personal hygiene.
They embarked on a small evidence-based practice study to investigate whether Derma Sciences’ MEDIHONEY® dressings, a unique key line of products whose active ingredient is medical-grade active Leptospermum honey (ALH), indigenous to New Zealand, would serve as a safe, effective, cost-efficient, user-friendly, moist wound healing dressing for use in this group of patients. They evaluated MEDIHONEY’s effectiveness in wounds and burns. The nurses incorporated MEDIHONEY as first-line therapy to not only clean the wound (debridement) but to also provide antimicrobial protection and healing. Princeton-based Derma Sciences, Inc. owns the global rights to MEDIHONEY.
Honey has been used as a wound dressing for centuries. Evidence for its medicinal use has been found in ancient writings. In modern times, it was in common use during World War I and II, but it began to wane in popularity with the rise of antibiotics around 1940. Only in the last decade have microbiologists begun to understand its precise medical benefits and the special properties of one particular variety: active Leptospermum (manuka) honey derived from the pollen and nectar of specific tea tree plants (Leptospermum scoparium). Researchers have found that the Leptospermum species, which is native to New Zealand, has unique plant-derived components that make it ideal for the management of failed wounds and burns.
Several patients seen in the study’s indigent outpatient wound clinic who presented with chronic, non-healing wounds were chosen to receive the MEDIHONEY dressings. After cleansing the wound, an appropriate MEDIHONEY dressing (honey impregnated calcium alginate for heavy exudates, honeycolloid or honey paste for light to moderate exudates) was applied and covered with a cover dressing. In their first case, they observed an obese 51-year-old male landscaper affected by diabetes, with a one-and-a-half-year-old ulcer on the bottom of his feet. Previous treatment included hydrogel, silver dressings, cadexomer matrix dressings, compression wraps, off-loading shoes and weekly debridement. A dressing was needed to manage exudate, prepare the wound bed and promote moist wound healing. After six months of unsuccessfuly healing this wound, the study authors tried MEDIHONEY’s calcium alginate bandage, covered with an absorbent foam and transparent film every other day. Complete healing was achieved after a few weeks on MEDIHONEY therapy.
In the case of a 66-year-old male with diabetes, who suffered from venous stasis ulcers and poorly controlled blood sugars, the challenge was to treat five infected, foul-smelling, heavily draining wounds on both legs. Prior treatment included compression bandaging. The nurses noted that excessive exudate and malodor were offensive to everyone in the outpatient wound center. A MEDIHONEY dressing was used to decrease the exudates and malodor, and helped prepare the wound bed and promote moist wound healing. The nurses applied a MEDIHONEY calcium alginate dressing, covered with an absorbent foam dressing, and covered with multilayer compression bandages once weekly. “The odor was immediately eradicated,” noted Maggio in the poster. “The exudates and wound size gradually decreased. By week 16 the wounds [were] well on the way to healing. The patient and staff [were] pleased with ease of use, odor management and wound healing.”
A second patient was a 49-year-old female with a hernia repair that resulted in a open wound that would not heal. The patient had been previously treated with negative pressure wound therapy (NPWT) while hospitalized. In preparation for discharge, the NPWT was to be discontinued and an antimicrobial dressing was needed to prevent infection of the exposed mesh. The nurses applied MEDIHONEY’s ALH paste along with an ALH-impregnated calcium alginate dressing and an absorbent cover dressing. The dressing was changed every other day. As Nurse Maggio notes, the wound gradually decreased in size. During week 18, surgical debridement with mesh removal was performed. The patient remained infection- free and the wound had almost completely healed by week 28. The last patient in the study was a 50-year-old healthy male with no diseases but who had sustained a traumatic injury to the dorsal surface of his foot, resulting in an exposed tendon. Previous treatment included daily application of a papain-urea-chlorphyliin enzymatic debriding agent with a gauze dressing. The wound was surrounded by erythema and debridement of necrotic tissue was slow. The MEDIHONEY dressings decreased redness, and prepared the wound bed and promote moist wound healing, noted the nurses.
The authors concluded that integrating MEDIHONEY into the wound care formulary of their indigent outpatient wound care clinic has not only improved healing outcomes but also decreased costs by eliminating the need for enzymatic debriding agents and multitple dressing types. “The dressings have enabled patients to participate easily in their own care, thus improving compliance for a variety of wound types. The antimicrobial effect may have prevented infection in several wounds,” noted the authors.
“When the cost of treatment in wound care is a consideration, as in the case of indigent patients, it is crucial to identify a therapy that is both effective and economically sound,” said Nurse Maggio. “The cases studied indicate that MEDIHONEY may be the ideal choice for caregivers faced with treating these particular patients.”
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Symposium on Advanced Wound Care (SAWC) and the Wound Healing Society (WHS),