German Hospital Treats Wounds Using Honey

Wound Care with Antibacterial Honey (Medihoney™) in Pediatric Hematology-Oncology

Mr. Kai Santos, Department of Pediatric Hematology and Oncology, Children's Hospital, University of Bonn, Adenauerallee 119, 53113, Bonn, Germany, kai.santos@ukb.uni-bonn.de

Presented at: 5th German Apitherapy Congress, March 23-25, 2007, Passau, Germany

The physiologic process of wound healing is impaired and prolonged in pediatric patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for seven years. Supplemented with clinical data from pediatric oncology patients, this article reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. To collect and analyze the available experience, we prepare an internet-based data documentation module for pediatric wound care with Medihoney.

Medihoney is a CE certified medicinal product for the specific treatment and care of wounds

Treatment of Wounds: Practical Examples

* Care of wound at entry point of hospital devices: long-term implantation of central vein catheter (port, Broviac), PEG-probe/tube, suprapubic bladder catheter
* Post-surgery treatment of wounds, suture dehiscence (also infected, e.g. with MRSA).
* Ulcers, decubitus ulcers odor
* Bedsores radiation dermatitis
* Burns
* Ulcerating tumor wounds

Activity Mechanism of Medihoney:

* Osmotic (anti-edematous) effect
* Formation of gluconic acid and hydrogen peroxide via the enzyme glucose-oxidase (The continuously-emitted amounts of H2O2 are not tissue-toxic but are bactericidal medicinal honey is still antibacterially active in a 5 % solution (MRSA) in which the glucose oxidase activity has been blocked.)

Clinical Activity:

* Anti-edematous effect: wound cleansing action antibacterial effect: wound sterilization
* Wound surface remains moist
* Accelerated granulation and epithelial growth does not damage granulation tissue and prevents or reduces pain when changing bandages reduces development of offensive wound odors

Materials Used in Conjunction with Medihoney:

* AQUACEL® forms a soft layer of gel when in contact with wound secretions and is able to absorb a large amount of liquid, even under pressure

* Calcium alginate as well as alkali and magnesium salts of alginic acid form a highly viscous gel in the presence of water or wound secretions

Algosteril® - Johnson & Johnson
Curasorb® - Tyco
Kaltostat ® - Convatec
Melgi Sorb ® - Mölnlyke
Sea Sorb Soft ® - Coloplast
Sorbalgon ® - Hartmann
Sorbsan ® - B. Braun
Suprasorb ® A - Lohrmann+Rauscher
Tegagen ® - 3M
Trionic ® - Johnson+Johnson

* Wound border area protection by means of preparations containing silicon, e.g. Cavillon® 3M, is recommended when frequent bandage changes are necessary
* Medihoney should remain on the wound until the next bandage change. Nearly all types of bandages are suitable.

Limitations and Side Effects:

* Formation of a honey crust due to gel remains
* Pain after application (high pH) especially with ulcus cruris (ca. 5 %)
* Local reactions (ca. 2 %), local eczema caused by Medihoney™
* Cost (80 Euros per 5-pack of Medihoney)