Novel Use of Active <i>Leptospermum</i> Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients

Lazarides, Alexander L.; Hamid, Kamran S.; Kerzner, Michael S

doi:10.1177/1938640017709907

Cited by 7 publications

(4 citation statements)

References 32 publications

(38 reference statements)

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“…Published articles about the potential effects of honey dressings on orthopaedic-related wounds are still scarce. Lazarides et al [ 14 ] used honey-impregnated dressings for ring fixator pin site care in 19 patients. Only two patients had superficial infection.…”

Section: Discussionmentioning

confidence: 99%

Honey dressing: a missed way for orthopaedic wound care

Ahmed

Eltregy

Kandil

2022

International Orthopaedics (SICOT)

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Purpose Orthopaedic-related wounds are critical situations calling for care to avoid deep infections and its consequences. The purpose of this study was to evaluate the efficacy of using honey for care of orthopaedic-related wounds with limited resources. Patients and methods This prospective study included 50 cases with an average age of 38.18 (range 17–63) years with 38 males and 12 females. The most frequent wound location was the leg (41 patients; 82%), then the foot (six patients; 12%), and the ankle in three patients (6%). The aetiologies were open fractures (34 cases; 68%), infected tibial non-unions (nine cases; 18%), and post-operative infections (seven cases; 14%). Exposed tendon was present in three cases. Bone exposure was present in two cases. Deep infection was present in 29 cases (58%). Besides treating the primary cause, a ribbon of gauze soaked with honey was applied to the wounds after thorough saline washing. Results Wound sizes were variable. All cases showed improvement in all parameters with complete wound healing and full coverage of bone and tendons. Recurrence of deep infection occurred in three cases and treated by debridement. One case needed sequestrectomy of a small exposed tibial cortical fragment. Exposed tendon cases showed superficial necrosis which was treated by simple debridement. Initial mild itching occurred in five patients with spontaneous resolution. Conclusion With treating the underlying aetiology and optimising the patient’s general condition, honey was an effective, simple, and affordable method of wound care in different orthopaedic conditions even with exposed bone or tendons.

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Section: Discussionmentioning

confidence: 99%

Honey dressing: a missed way for orthopaedic wound care

Ahmed

Eltregy

Kandil

2022

International Orthopaedics (SICOT)

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“…A further study showing clinical comparisons with the authors in vitro study is that of Lazarides and colleagues (42). Researchers in this prospective case series, which included 19 patients with diabetes with a Charcot foot undergoing external xation, applied honey (Medihoney® patches) to pin sites at the end of the procedure, replacing weekly for a total of 8 weeks.…”

Section: Discussionmentioning

confidence: 99%

The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacteria present in foot and ankle post-surgical wounds

McArdle

Coyle

Santos

2023

Preprint

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Surgical Site Infections (SSIs) are amongst the most troublesome complications following foot and ankle surgery (FAS) and have significant psychosocial and financial burden for both patients and the healthcare system. FAS has been reported to have higher than average post-surgical infections when compared to other orthopaedic subspecialties. Evidence also indicates that patients with diabetes and other co morbidities undergoing FAS are at a much greater risk of developing SSIs. Patients with SSIs face additional exposure to bacteria circulating in hospitals, which are always charged with microbial pathogens. With the growing challenges of antibiotic resistance and the increasingly high numbers of resilient bacteria to said antibiotics, the need for alternative antimicrobial therapies has become critical. Aim:The aim of this study was to investigate the use of medical grade honey (MGH) when altered to environments typically present in wounds (pH6-8). Methods:MGH (Activon) was altered to pH 6, 7 and 8 and experimental inoculums of Pseudomonas aeruginosa (NCTC10782), Escherichia coli, (NCTC10418), Staphylococcus aureus (NCTC10655) and Staphylococcus epidermidis (NCTC 5955) were transferred into each pH adjusted MGH and TSB solution and the positive and negative controls. Results: MGH adjusted to various pH values had the ability to reduce bacteria cell survival in all pH variations for all bacteria tested, with the most bacterial reduction/elimination noted for Staphylococcus epidermidis. No correlations were noted among the pH environments investigated and the colony counts, for which there were small amounts of bacteria survived. Conclusion: This in vitro research would indicate that the antibacterial properties of honey remains the same regardless of the pH environment. MGH could therefore potentially be considered for use on non-infected post-surgical wounds to reduce the bacterial bioburden, the risk of SSIs and ultimately to improve healing outcomes.

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“…A further study showing clinical comparisons with the authors in vitro study is that of Lazarides and colleagues [ 47 ]. Researchers in this prospective case series, which included 19 patients with diabetes with a Charcot foot undergoing external fixation, applied honey (Medihoney® patches) to pin sites at the end of the procedure, replacing weekly for a total of 8 weeks.…”

Section: Discussionmentioning

confidence: 99%

The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacterial isolates present in common foot and ankle wounds. An in vitro study

McArdle,

Coyle,

Santos

2023

Journal of Foot and Ankle Research

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Background Diabetic foot ulcers (DFUs) and post-surgical wound infections are amongst the most troublesome complications of diabetes and following foot and ankle surgery (FAS) respectively. Both have significant psychosocial and financial burden for both patients and the healthcare system. FAS has been reported to have higher than average post-surgical infections when compared to other orthopaedic subspecialties. Evidence also indicates that patients with diabetes and other co morbidities undergoing FAS are at a much greater risk of developing surgical site infections (SSIs). With the growing challenges of antibiotic resistance and the increasingly high numbers of resilient bacteria to said antibiotics, the need for alternative antimicrobial therapies has become critical. Aim The aim of this study was to investigate the use of medical grade honey (MGH) when altered to environments typically present in foot and ankle wounds including DFUs and post-surgical wounds (pH6-8). Methods MGH (Activon) was altered to pH 6, 7 and 8 and experimental inoculums of Pseudomonas aeruginosa (NCTC10782), Escherichia coli, (NCTC10418), Staphylococcus aureus (NCTC10655) and Staphylococcus epidermidis (NCTC 5955) were transferred into each pH adjusted MGH and TSB solution and the positive and negative controls. Results MGH adjusted to various pH values had the ability to reduce bacteria cell survival in all pH variations for all bacteria tested, with the most bacterial reduction/elimination noted for Staphylococcus epidermidis. No correlations were noted among the pH environments investigated and the colony counts, for which there were small amounts of bacteria survived. Conclusion This research would indicate that the antibacterial properties of honey remains the same regardless of the pH environment. MGH could therefore potentially be considered for use on non-infected foot and ankle wounds to reduce the bacterial bioburden, the risk of infections and ultimately to improve healing outcomes.

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Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients

Abstract: Level IV.

Cited by 7 publications

References 32 publications

Honey dressing: a missed way for orthopaedic wound care

Honey dressing: a missed way for orthopaedic wound care

The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacteria present in foot and ankle post-surgical wounds

The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacterial isolates present in common foot and ankle wounds. An in vitro study

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