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Clinical Research
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Honey bee for treatment of leg ulcers Vanesa Cuevas Moreno, Judith Dominguez-Cherit, Rodrigo Roldán-Marin, Maria Cristina-Sosa de Martinez, Jose Contreras-Ruiz, Gea Gonzalez General Hospital, D.F., Mexico Background: Stasis ulcers represent a serious cause of disability amongst the economically active population. The costs involved in their treatment are high. Honey has been used in case series for the treatment of chronic ulcers (including venous leg ulcers) as a cheap and accessible alternative. Objective: To evaluate the healing rate and the effect of bacterial burden in venous leg ulcers treated with honey and alginate compared with those treated solely with calcium alginate. .Method: Pilot, randomized, controlled, prospective, longitudinal, with blinded evaluator and statistician trial. Thirteen patients were randomized to receive either honey and a calcium alginate dressing with compression, or just a calcium alginate dressing with compression Results: Five men and 6 women. Mean age was 68 in group 1, and 69 in group 2. (P= 0.9). The mean time chronicity was 48 and 108 months, respectively (P= 0.7). When comparing both groups we did not observe statistical difference in the beginning nor in the end of trial concerning the healing rate, the area of the ellipse, and wound bed appearance. The most frequently found bacteria overall was S. aureus. Two patients droped out of the study (one due to worsening in the control group and the other one due to loss of follow up appointments). An increase in exudate amount, foul odour and pain were the most commonly present side effects. Conclusions: We did not find that honey is being better than conventional management to diminish the size of venous leg ulcers neither accelerating healing rate. Honey does not seem to reduce bacterial burden in venous ulcers compared to standard care although cultures should be either quantitative or semi quantitative. Valencia IC, Falabella A, Kirsner RS, Eaglstein WH. Chronic venous insufficiency and venous leg ulceration. J Am Acad Dermatol. 2001;44:401Ð421 Harding KG, Morris HL, Patel GK. Science, medicine and the future: healing chronic wounds. BMJ. 2002;324:160Ð163 Trent JT, Falabella A, Eaglstein WH, Kirsner RS. Venous ulcers: pathophysiology and treatment options. Ostomy Wound Manage. 2005;51:38Ð54 Sibbald RG, Orsted H, Schultz GS, Coutts P, Keast D. Preparing the wound bed 2003: focus on infection and inflammation. Ostomy Wound Manage. 2003;49:23Ð51 Kunimoto B, Cooling M, Gulliver W, Houghton P, Orsted H, Sibbald RG. Best practices for the prevention and treatment of venous leg ulcers. Ostomy Wound Manage. 2001;47:34Ð50 Bowler PG, Davies BJ. The microbiology of infected and noninfected leg ulcers. Int J Dermatol. 1999;38:573Ð578 Bowler PG. The 10(5) bacterial growth guideline: reassessing its clinical relevance in wound healing. Ostomy Wound Manage. 2003;49:44Ð53 Molan P. The antibacterial activity of honey. Variation in the potency of the antibacterial activity. Bee World. 1992;73(2):59Ð76 Molan PC. Re-introducing honey in the management of wounds and ulcersÑtheory and practice. Ostomy Wound Manage. 2002;48:28Ð40 Al-Waili NS, Saloom KY. Effects of topical honey on post-operative wound infections due to gram positive and gram negative bacteria following caesarean sections and hysterectomies. Eur J Med Res. 1999;4:126Ð130.. |
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