Saturday, June 02, 2007

Study: Honey-Treated Wounds Heal Better, Faster

Derma Sciences Announces Preliminary Results of Study Involving Active Manuka Honey at European Wound Management Conference

PRINCETON, N.J.--(BUSINESS WIRE)--Derma Sciences, Inc. (OTCBB: DSCI), a manufacturer and supplier of advanced wound care products, announced that the results of a randomized controlled trial (RCT) using Active Manuka Honey in the treatment of chronic wounds was announced at the European Wound Management Association’s annual conference held in Glasgow, Scotland. The complete findings of the study will be published in an international journal in Q4, 2007. Preliminary results were presented at the conference by the study’s primary investigator, Georgina Gethin…

After the treatment period, it was determined that the group treated with honey experienced a higher rate of debridement, significantly faster healing, and reduced infection than in the group treated with the standard gel…

Manuka Honey Versus Hydrogel to Deslough Venous Leg Ulcers: A Randomised Controlled Trial
Georgina Gethin, Seamus Cowman
Royal College of Surgeons, Dublin, Ireland

Aims: to determine if Manuka honey could deslough venous leg ulcers in comparison to a standard agent. To determine the % of wounds healed after 4 and 12 weeks in each group. To quantify the effects on healing when wounds are desloughed. To determine changes in qualitative bacterial culture wound swabs over 4 weeks when both treatments were used.

Methods: prospective, open label, multicentre, randomised controlled trial. Randomisation via remote telephone. Wounds with 50% area covered in slough were included. WoundCare 18+ (Comvita) or IntraSite Gel (Smith +Nephew) were applied once or twice weekly for 4 weeks in conjunction with compression therapy, followed by appropriate care based on clinical evaluation for next 8 weeks. Outcome measures included;% area covered in slough, wound size, healing rates, culture swab results, level of exudate, pain scores. Analysis was on intention to treat basis. Ethical approval was granted prior to commencement.

Results: 35 males, 73 females age 24-89 years (mean 73 yrs) recruited from 8 centres over 34 months. Baseline comparability was established. At week 12: 30% (n=24) in honey group and 21% (n=18 gel) healed. Reduction in wound size after 12 weeks reported a 1.38 risk of healing in the honey group compared to control (p = 0.037). The mean wound area covered in slough after 4 weeks was 29% (honey) v 43%(gel) (p0.065). A slough reduction of 50% or more after 4 weeks was associated with a higher probability of healing at 12 weeks (RR 3.3, p = 0.29). Epithelization was visible earlier in honey group v gel (p 0.042). Wounds of longer duration and largest size had the highest number of pathogens. MRSA was recorded at baseline in 16% (n=18) cases. Of the 10 honey treated wounds with MRSA at baseline, it was not evident after 4 weeks in 9 cases.

Conclusion: the probability of sloughy venous ulcers healing after 12 weeks is higher when wounds are effectively desloughed and when Manuka honey is used compared to control. It is recommended that further research is conducted to investigate the clearance of MRSA from chronic wounds when honey is used.

Other Research Presented at the Conference:

An Evaluation of a Medical Honey Dressing in Intractable Wounds

An evaluation of a medical honey dressing* was undertaken over a 4 week period involving 25 patients with a variety of intractable wounds. This clinical study was based on a series of case studies. The overall aim was to demonstrate how a medical honey dressing* can be used in general, hard to heal wounds and whether a lowered pH value, reduced colonisation and odour can be used as markers of reduced infection potential and signs of healing…

*Melmax®

Wounds Post Coronary Artery Bypass Grafts

This poster presents a series of four case studies with photographic evidence and assessment results including pain control, exudate management, odour control, patient comfort and wound progression from the use of medical honey antibacterial wound gel.

Results: These case studies demonstrate that the use of medical honey antibacterial wound gel led to improved healing outcomes, reduction in pain, reduction in exudate, reduction in odour and improved patient comfort.

The Use of Topical Medical Honey Antibacterial Gel in Leg Ulcer Management

Three patients with chronic leg ulceration were assessed as potentially benefiting from the action of medical honey to achieve wound healing. Patient selection was based on structured leg ulcer assessment rather than dressing available. Aetiology of ulceration in patient 1 was mixed arterial and venous, and in patient 2 and 3, venous. All had several years’ history of reoccurrence. Primary target in all patients was to encourage healing, protect from infection and to reduce pain.

Results: Patient 1 ­ There was a significant reduction in pain during dressing change and between dressing changes; plus, biofilm reduction with resultant granulation and epithelialisation.
Patient 2 ­ Debris was significantly reduced after only one application, sufficient to allow compression therapy reinstatement and early discharge to community care.
Patient 3 ­ Application encouraged slough removal, reduced microbial load, reduction in pain and increased psychological and physical comfort.

Discussion: Promotion of healing occurred in all instances with a reduction in the incidence of infection and the provision of comfort. Medical honey should therefore be considered as a topical dressing in the treatment of chronic leg ulceration given appropriate structured and holistic assessment.

MIC’s of Selected Honeys Against Clinical Bacterial Isolates from Surgical Wounds

A study was undertaken to determine in vitro Minimum Inhibitory Concentrations (MIC) of a Manuka honey of known UMF and of two previously untested Scottish Heather honeys.

Methods: 80 strains of 24 bacterial species were isolated from wound swabs sent to the laboratory in the course of clinical investigations. These isolates included MRSA and VRE. Honey MICs were determined for each of the strains using a standard method for antibiotic MIC testing (NCCLS).

Results: The bacteriostatic properties of all three honeys were established in vitro, with MICs ranging from 1% to 12% v/v honey. In most cases there was little difference in susceptibility among strains of a given species, regardless of any variations is antibiotic susceptibility.

Discussion: Both Manuka and Heather Honey exhibited antimicrobial activity. Honey could therefore be expected to exhibit the same clinically useful effects in vivo. The clinical usefulness of such activity is being evaluated as part of a wider in vivo study. However, early results indicate potential clinical usefulness.

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