In diabetic patients, metatarsal excision may be better than transmetatarsal amputation.

Three case studies of patients with leg ulceration are used to illustrate the effectiveness of Medihoney™ antibacterial wound gel (Medical honey) in wound healing via wound bed preparation. The aim was to improve the patient’s quality of life, during the healing process, through provision of comfort, reduction in pain and protection from infection. 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. The 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. Promotion of healing occurred in all instances with a reduction in the incidence of infection, reduction in pain and the provision of comfort. Antibacterial medical honey should therefore be considered as a dressing option when assessing and managing chronic wounds.