Treating severe wounds in pediatrics with medical grade honey: A case series

Smaropoulos, Eleftherios; Cremers, Niels A. J.

doi:10.1002/ccr3.2691

Cited by 32 publications

(43 citation statements)

References 39 publications

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“…Honey is used for wound healing since ancient times because of its broad-spectrum antimicrobial and wound-healing activities [ 6 ]. Antibiotics replaced the use of honey, but the development of antibiotic resistance returned its use [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Hydrogen peroxide is formed by the enzyme glucose oxidase, which the bees add to the honey, and it catalyzes glucose in the presence of water and oxygen into gluconic acid and hydrogen peroxide (C 6 H 12 O 6 + H 2 O + O 2 → gluconic oxidase→ C 6 H 12 O 7 + H 2 O 2 ). Moreover, other molecules present in MGH also have a direct antimicrobial effect, such as phenolic compounds, flavonoids, methylglyoxal, and Bee defencin-1 [ 6 ]. Since the antimicrobial activity of MGH is based on multiple mechanisms, microorganisms are not capable of developing resistance toward MGH [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series

et al. 2020

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Diabetic ulcers are at risk of becoming chronic and infected, as diabetics have hampered vascular structures, limiting oxygen and nutrient supply. These wounds can lead to pain, malodor, functional problems, and amputation. The current rise in antibiotic resistance demands for complementary therapies. Medical-grade honey (MGH) forms an attractive option because of its antimicrobial and pro-healing properties. We aim to show the beneficial effects of MGH in infected diabetic ulcers. We present six patients with infected diabetic ulcers, of which some were at risk of (further) amputation. Previous treatments with antibiotics, silver and alginate dressings, surgical closure, and maggot therapy were ineffective; therefore, the treatment was switched to the application of MGH. MGH therapy typically reduced the malodor in a couple of days and controlled infection within 2–3 weeks. MGH also enhanced wound healing by promoting granulation tissue formation, angiogenesis, and re-epithelialization, by decreasing inflammatory and oxidative stress and providing nutrients. Together, wound healing was enhanced, and the patient’s quality of life improved. MGH is safe and cost-effective for treating complicated diabetic wounds with (antibiotic-resistant) infections and at risk of amputation. MGH forms a promising alternative or complementary therapy to replace antibiotics for treating locally infected wounds.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series

et al. 2020

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“…MGH is strictly controlled and extensively tested honey, guaranteeing its safety and efficacy for medical purposes [19]. MGH exerts both broad-spectrum antimicrobial activity and wound-healing-promoting properties [20][21][22][23]. The main antimicrobial activities of MGH are thought to rely on the low pH, osmotic activity, production of hydrogen peroxide, and the presence of antimicrobial molecules (e.g., phytochemicals such as flavonoids).…”

Section: Introductionmentioning

confidence: 99%

“…Since the antimicrobial activity is attributed to multiple mechanisms, no resistance towards honey has been reported so far [24]. The wound-healing properties are multifaceted and mediated by creating a moist wound environment, stimulation of autolytic debridement and angiogenesis, anti-inflammatory and antioxidative activity, enhanced cell migration, proliferation, and re-epithelialization [20][21][22][23]. In a recent systematic review paper about honey in wound care, analyzing 30 randomized controlled studies, it was concluded that honey decreased the time of wound healing and was cost-effective [25].…”

Section: Introductionmentioning

confidence: 99%

Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication

et al. 2020

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Biofilms hinder wound healing. Medical-grade honey (MGH) is a promising therapy because of its broad-spectrum antimicrobial activity and the lack of risk for resistance. This study investigated the inhibitory and eradicative activity against multidrug-resistant Pseudomonas aeruginosa biofilms by different established MGH-based wound care formulations. Six different natural wound care products (Medihoney, Revamil, Mebo, Melladerm, L-Mesitran Ointment, and L-Mesitran Soft) were tested in vitro. Most of them contain MGH only, whereas some were supplemented. L-Mesitran Soft demonstrated the most potent antimicrobial activity (6.08-log inhibition and 3.18-log eradication). Other formulations ranged between 0.89-log and 4.80-log inhibition and 0.65-log and 1.66-log eradication. Therefore, the contribution of different ingredients of L-Mesitran Soft was investigated in more detail. The activity of the same batch of raw MGH (1.38-log inhibition and 2.35-log eradication), vitamins C and E (0.95-log inhibition and 0.94-log eradication), and all ingredients except MGH (1.69-log inhibition and 0.75-log eradication) clearly support a synergistic activity of components within the L-Mesitran Soft formulation. Several presented clinical cases illustrate its clinical antimicrobial efficacy against Pseudomonas aeruginosa biofilms. In conclusion, MGH is a potent treatment for Pseudomonas biofilms. L-Mesitran Soft has the strongest antimicrobial activity, which is likely due to the synergistic activity mediated by its supplements.

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“…The honey likely interacts with the local cells, stimulates them through various signaling mechanisms, and then these cells further signal to other local and migrating cells. For example, when honey is applied to a wound bed, such as an ulcer or non-healing wound, some of its' observed functions include: autolytic debridement, wound healing, inflammatory modulation and bacterial killing 12,68,69 . How all of these functions are achieved with the application of high concentrations of honey, > 50%, when it is observed in vitro that > 1% of honey is cytotoxic, supports the idea that we do not fully understand all of the mechanisms and chemicals within this "neutraceutical".…”

Section: Study Limitationsmentioning

confidence: 99%

Manuka honey microneedles for enhanced wound healing and the prevention and/or treatment of Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection

Frydman

Olaleye

Annamalai

et al. 2020

Sci Rep

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Manuka honey (MH) is currently used as a wound treatment and suggested to be effective in Methicillin-resistant Staphylococcus aureus (MRSA) elimination. We sought to optimize the synthesis of MH microneedles (MHMs) while maintaining the MH therapeutic effects. MHMs were synthesized using multiple methods and evaluated with in vitro assays. MHMs demonstrated excellent bactericidal activity against MRSA at concentrations ≥ 10% of honey, with vacuum-prepared honey appearing to be the most bactericidal, killing bacterial concentrations as high as 8 × 10 7 CFU/mL. The woundhealing assay demonstrated that, at concentrations of 0.1%, while the cooked honey had incomplete wound closure, the vacuum-treated honey trended towards faster wound closure. In this study, we demonstrate that the method of MHM synthesis is crucial to maintaining MH properties. We optimized the synthesis of MHMs and demonstrated their potential utility in the treatment of MRSA infections as well as in wound healing. This is the first report of using MH as a substrate for the formation of dissolvable microneedles. this data supports the need for further exploration of this new approach in a wound-healing model and opens the door for the future use of MH as a component of microneedle scaffolds. Surgical site infections (SSIs) have historically been associated with increased morbidity and mortality but remain an issue in modern day healthcare. As of 2017, the Centers for Disease Control and Prevention (CDC) estimated that SSIs occurred in at least 1.9% of all surgical patients; however, this number is most likely not representative of the total number of SSI cases since about 50% of SSIs occur after hospital discharge 1,2. MRSA is the most common cause of SSIs leading in an increased morbidity in patients and increased hospital charges 3,4. In a study evaluating the 90-day mortality rate in patients with SSI, it was discovered that patients with a methicillin-resistant Staphylococcus aureus (MRSA) SSI had a 3.40 times increased mortality rate (95% CI, 1.5-7.2) than patients infected with a methicillin-susceptible S. aureus strain 5. Given the health and economic burden attributable,

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Treating severe wounds in pediatrics with medical grade honey: A case series

Abstract: Medical grade honey (MGH) has antimicrobial and pro‐healing properties. We here demonstrate that MGH is an easily applicable, safe, and cost‐effective approach for severe wounds. The use of MGH should more often be considered to treat all kinds of pediatric wounds.

Cited by 32 publications

References 39 publications

Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series

Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series

Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication

Manuka honey microneedles for enhanced wound healing and the prevention and/or treatment of Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection

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