The effect of honey‐coated bandages compared with silver‐coated bandages on treatment of malignant wounds—a randomized study

Abstract

Malignant wounds (MWs) occur in 5-10% of all cancer patients. Malodor and exudation are the most common side effects. The aim was to determine the influence of honey-coated compared with silver-coated bandages on treatment of MWs. Patients were randomly selected to enter either group A (honey-coated bandages) or group B (silver-coated bandages). Parameters were the following: wound size, cleanliness, malodor, exudation, and wound pain. Digital photographs, visual analog scales (VAS), and wound morphology registration were used for measurement at baseline and following the 4-week intervention. Sixty-nine patients with MWs and advanced cancer, aged 47-90 (median 65.6), were included. No statistically significant difference was noted between the groups with respect to wound size, degree of cleanliness, exudation, malodor, and wound pain. There was a median decrease in wound size of 15 cm² and 8 cm² in group A and B, respectively (p = 0.63). Based on post-intervention pooled data from the groups, improvement was seen in 62% of the participants with respect to wound size and in 58% (n = 69) with respect to cleanliness. The VAS score for malodor (p = 0.007) and exudation (p < 0.0001) improved significantly post-intervention. Patients with reduced wound size had a median survival time of 387 days compared with 134 days in patients with no wound reduction (p = 0.003). The use of honey-coated and silver-coated bandages improved the outcome of MWs. No differences were found between the two regimens. Both types of bandages are recommended for use by patients with MWs containing tumor debris and necrosis.

A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds

“…An "Overall Evaluation Scale" was usually used to measure the eff ectiveness of a dressing to control odor rather than odor intensity. 29 Th e scales changed statistically before and following treatment using either paired t test, 30 the Friedman test, 31 the Spearman test, 32 or Mann-Whitney U test, 33 supporting their responsiveness to intervention. Nevertheless, statistical analysis was not always possible due to diff erences in responses reported by health care providers versus patients.…”

“…49 , 50 Some manufacturers impregnate silver nanoparticles into foam dressings; examples include Allevyn Ag (Smith-Nephew plc, UK), 7 Urgocell Silver (Urgo Medical, Chenove, France), 53 and Acticoat (Smith-Nephew plc, UK). 33 Another dressing (Actisorb Silver 220, Systagenix) contains silver particles attached to carbon particles. 54 , 55 Th is product exerts both direct and indirect odor control properties; the charcoal directly absorbs odorous gases, while the silver indirectly reduces odor by killing any bacteria captured by the charcoal.…”

Neoplastic wounds: controlling pain, exudate, odor and bleeding

“…It is important to emphasize that, in addition to the previously mentioned drugs, studies have been recommending some important measures to reduce pain, such as cleaning the lesion through irrigation or with Metzembaum tweezers [20], in order to avoid further tissue trauma. Furthermore, careful selection of covers with atraumatic and non-adherent interfaces have been widely used, in order to limit damage to the skin and, therefore, reduce pain at the time of dressing removal.…”

“…[2,21] Pain management is complex because it involves not only the pain itself, but also anxiety, anguish and apprehension related to the dressings. [17] In this sense, studies [19][20] emphasize the importan-ce of complementary therapies in the treatment of pain in neoplastic wounds. Complementary therapies include massages, acupuncture, aromatherapy, relaxation therapy, psychotherapy among others.…”

“…[1, 3-5, 17, 19, 28] Moreover, excessive amounts of exudate may exceed the primary and secondary coverages, soiling the patient's clothing, causing significant psychosocial problems for the patient, so the control of that symptom becomes urgent. [1, 3-5, 17, 19, 28] In order to avoid bacterial proliferation, infectious process and bad odor, authors [20] have recommended cleaning the lesion with medicinal liquid soap or Polyhexamethylene biguanide (PHMB) [17] or using Octenisept-saturated gauzes [26] as the primary cover of exudative lesions that present an infectious process and a foul odor, since they observed a significant reduction of those signs and symptoms present in the wounds of the research subjects.…”