From: Jacqueline Paltis [jacpal@earthlink.net]
Sent: Wednesday, September 27, 2006 9:54 AM
To: Khelly Webb
Subject: Sugar/Honey Wound Dressings
Here are two articles In found on the web relating to sugar/honey wound dressings. The first is about honey, which would probably be easier to do at home.
http://www.bees-online.com/HoneyAsTreatmentForWoundsAndBurns.htm
Honey – Natural Treatment for Wounds and Burns
By Junji Takano
Honey is a highly concentrated sugar solution produced by honeybees. It is commonly used as substitute for sugar or a flavor enhancer. But other than that, honey is also effective in treating burns and wounds and it has been used for this purpose for many centuries.
Now it is known that the secret of honey lies on its antibacterial activity.
How Can Honey Stop Infection? We know that bacteria love sugar, but why most bacteria and other microorganisms cannot grow or reproduce in honey?
Here are the reasons:
1. Acidity – Honey is acidic, and acids prevent the growth of bacteria.
2. Hydrogen Peroxide – When honey is applied as a wound dressing, it is diluted with fluids from the damaged tissue and combines with an enzyme added by the bee to form hydrogen peroxide, the same antiseptic found in drugstores. Diluted honey can serve as an excellent antiseptic because the naturally occurring hydrogen peroxide won’t harm the tissues and no scarring will occur.
Applying Honey as a Wound Dressing
1. Usually, 20 ml of honey (25 – 30 g, 1 ounce) is enough on a 10 cm X 10 cm (4 inch X 4 inch) dressing. The honey dressings should be cut to a size that extends beyond the edges of the wound.
2. To prevent honey oozing out from the wound dressing, waterproof dressings are needed. Absorbent dressings are not recommended as they soak the honey making it less effective. Adhesive tape or bandages can be used to hold the dressings in place.
3. It is better to spread the honey on the dressing first before applying it on the wound area.
4. If there are abscesses in the wound area, fill it with honey before applying the dressing pad, so that there is honey in contact with the wound.
5. The amount of honey required on the wound depends on the amount of fluid it exudes. Honey will be useless if it is diluted by large amounts of fluid. Also the frequency of dressing changes depends on how fast the honey is being diluted by fluid.
6. On deeper infections, more honey is required to get an effective antibacterial activity.
7. Daily dressing changes up to three times daily may be needed.
8. Exudation of fluid should be reduced after few days use of honey dressing. During this time, less dressing changes will be needed.
Honey Used as Medicine: Below are some common problems which can easily be prevented from the use of honey:
1. Allergies – Raw honey is an excellent treatment for 90% of allergies.
2. Anemia – Honey is a great blood enricher. The darker the honey the better. Take 1 ripe banana with 1 tablespoon of honey, 1-2 times a day.
3. Appetite – Honey improves appetite in children suffering from appetite loss.
4. Conjunctivitis – Dissolve honey in equal amount of warm water. When cooled, apply as lotion or eye bath.
5. Fatigue and exhaustion – Honey is the best ingredient to remove tiredness and fatigue almost instantly because it is easily absorbed in the blood. Dissolve 1 teaspoon of honey in warm water or quarter honey balance of water in a jug and keep in the fridge.
6. Headaches and Migraine – Take 2 teaspoons at meals to prevent headache. For migraines, take 1 dessertspoon of honey dissolved in a half glass of warm water. Repeat in 20 minutes if migraine persists.
7. Heart Diseases – Honey can fight against cholesterol. Pure honey taken with foods daily instead of sugar relieves complains of cholesterol. This is helpful for old people, especially sufferers of diabetes, heart disease, high blood pressure and others.
8. High Blood Pressure – Take mixed 1 teaspoon of honey, 1 teaspoon of ginger juice and 1 teaspoon of cumin powder 2 times a day.
9. Insomnia (Sleeplessness) – Take 1 teaspoon of honey mixed in lukewarm water or milk and drink before going to bed.
10. Poor Digestion – Mix 1:1 honey with cider vinegar and dilute with water.
11. Skin – Honey is a good moisturizer. It also helps in reducing skin problems like pimples.
12. Sore Throat – Let 1 teaspoon of honey melt in the back of the mouth and trickle down the throat.
13. Stomachache – Take 1 teaspoon of honey, juice of a 1Ž2 lemon with a hot glass of water first thing in the morning.
14. Teeth – Although honey is sweet, it helps to maintain and protect teeth. Important: Honey contains a certain bacterium that might be harmful in infants; it should never be fed to children younger than one year old. Otherwise it could lead to food poisoning.
Now you know that when honey is applied properly to a wound, it can promote healing just as good as or often better than, over-the-counter ointments and dressings. It is also a great preventive medicine on common ailments.
About The Author: Junji Takano is a Japanese health researcher and has been studying the causes of viruses since 1960s. In 1968, he invented Pyro-Energen, the first electrotherapy device that eradicates viral diseases in a non-narcotic way.
Visit him at: http://www.pyroenergen.com Free newsletter: http://www.pyroenergen.com/newsletter.htm
Article Source: http://EzineArticles.com/
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http://www.smtl.co.uk/WMPRC/DressingsTimes/vol3.2.txt
Welcome to the eighth edition of the Dressings Times in which Dr Keith Middleton of the Pharmacy Department, Northwick Park Hospital provides an interesting account of the use of sugar paste in wound management.
Sugar Pastes in Wound Management
In 1976, Herszage and Montenegro of Argentina used ordinary sugar to treat the wounds of two patients with post-surgical necrotic cellulitis. Further successes followed and in 1980 they reported on the use of sugar paste in 120 infected wounds and recorded a cure rate of 99.2%.[1] The time taken for the wounds to heal varied between 9 days and 17 weeks, but it was observed that odour and secretion began to diminish within 24 hours and disappeared totally after 72 to 96 hours of treatment. In 1985, Trouillet et al[2] described
the use of sugar in the treatment of 19 patients with acute mediastinitis following cardiac surgery. Wounds were packed every 3 to 4 hours with ordinary commercially available granular sugar (sucrose). The authors noted near complete debridement followed by the rapid formation of granulation tissue and eradication of bacterial infection after an average of 7.6 days of treatment.
Sugar was first used as a dressing in Northwick Park Hospi-
tal in 1982 when it was placed into infected radical vulvec-
tomy wounds that had not responded to more conventional
therapies. However, due to the nature of such wounds, pack-
ing with granular sugar was found to be impossible and
therefore a thick paste was developed. Other early patients
to be treated with sugar at Northwick Park were two hypo-
gammaglobulinaemic individuals who had developed extensive
tracking sinuses. For these, a thin paste was formulated
that could be injected into the narrow wounds.
Thick sugar paste has a consistency similar to that of mod-
elling clay and can be moulded in the gloved hand immediate-
ly prior to packing into cavities with large openings such
as pressure sores. Thin sugar paste resembles thin honey; it
is suitable for instillation into cavities with small open-
ings with a syringe and fine plastic tube or catheter.
Formulae for sugar pastes
Thin Thick
Caster sugar 1200g 1200g
(fine granular sucrose)
Icing sugar – additive free 1800g 1800g
(powdered sucrose)
Polyethylene glycol 400 1416ml 686ml
Hydrogen Peroxide 30% 23.1ml 19ml
(Final concentration of hydrogen peroxide is 0.15% v/w.)
The pastes are prepared in the hospital pharmacy by combin-
ing the H2O2 with the PEG 400 and then incorporating this
solution into the sugars with the aid of a mechanical mixer.
When homogenous the paste is packed into screw capped plas-
tic containers and stored at 4C. The pastes are chemically
stable for at least 6 months from preparation.
Polyethylene glycol (PEG) 400 was chosen as the lubricant
because it does not interact with other components of the
paste and is used in a variety of pharmaceutical prepara-
tions. It is a synthetic polymer that is also used in the
cosmetic industry and has significant anti-bacterial proper-
ties. [3][4] Polyethylene glycol 400 can be absorbed from
mucous membranes and high blood levels may be
nephrotoxic.[5] Although no toxic effects have been noted in
our patients, many of whom are elderly and frail, sugar
paste should be used with care in patients with impaired re-
nal function as any absorbed polyethylene glycol is excreted
renally.
Sugar paste has been used on most wound types but it has
been found to be particularly effective for treating infect-
ed and malodorous wounds. Twice daily application are ad-
vised to provide the optimum antibacterial effect. This has
been demonstrated both in patients with malodorous wounds
(when the smell of infected necrotic tissue is removed after
2-3 days), and in patients with infected abscesses. Irriga-
tion with thin sugar paste has achieved successful results
in patients with chronic discharging sinuses who had previ-
ously failed to respond to other therapies. Repeated appli-
cation over 3 to 6 weeks is generally required to bring
about complete healing. Sugar paste lowers the pH of wounds
to approximately 5 which may be important in infected wound
although the paste does not stimulate or retard granulation
tissue formation in clean wounds in the pig model.[6]
Sugar paste (thick and thin) is rapidly bactericidal against
all organisms so far tested when challenged according to a
modified British Pharmacopoeia antimicrobial preservatives
effectiveness test. When samples of the paste were inocu-
lated with Staphylococcus aureus, Streptococcus faecalis,
Escherichia coli or Candida albicans, to give 105 cfu/gram,
less than 10 cfu/gram were detectable after 1 hour at
25C.[7] Pastes diluted with serum have a reduced bacterici-
dal effect – 75% paste in serum gave an 80% reduction in vi-
able numbers of S. aureus within 2 hours and a 99% reduction
in viable numbers of Proteus mirabilis within 1 hour[3].
Although the application of sugar to a wound creates an en-
vironment with low water activity (aw) and high osmotic
pressure, overall the wound remains moist. (The water activ-
ity of a solution is the ratio of its water vapour pressure
to that of pure water at the same temperature so that aw =
P/Po).
The effect of reducing water activity values on the growth
of bacteria has been investigated by Chirife et al[8] who
determined the limiting water activities at which different
species of bacteria will grow. We have determined the water
activity of our pastes, at different dilutions in serum, by
measuring water vapour pressure at 25C with an electronic
hygrometer. Undiluted pastes have an almost zero availabili-
ty of water because the sugar (sucrose) is dispersed in
Polyethylene glycol 400 which does not contain water. Sugar
has an osmotic action which can be thermodynamically related
to water activity by the following equation.[8]
= (RT/V) x log (1/aw),
where = osmotic pressure,
R is the gas constant,
T is the absolute temperature in degrees kelvin,
V is the partial molal volume of water and
aw is the water activity.
Thus, by determining water activity, the osmotic pressure
can be calculated. From this equation it will be seen that a
solution of low water activity has high osmotic pressure.
Because of the difficulty of conducting a controlled trial
of sugar paste in human wounds, an animal study has been
conducted[6] using a method similar to that reported by Win-
ter and Scales.[9] Full thickness wounds 25 mm square, and 9
mm deep were made in the backs of pigs and around each was
placed a colostomy stoma ring. This in turn was covered with
a semipermeable plastic film dressing (Opsite) so as to form
a moist chamber. Wounds were either covered with Opsite
alone, or packed with thick sugar paste or cotton gauze
soaked in various antiseptic solutions and then covered in
Opsite. The results showed that there was no significant
difference between wounds left unpacked, but covered with
Opsite, and those Opsite covered wounds packed with sugar
paste, indicating that although sugar paste did not stimu-
late the formation of granulation tissue, neither did it
cause inhibition or toxicity. However, all wounds packed
with antiseptics showed evidence of delayed healing, espe-
cially those containing chlorhexidine gluconate 0.2%. The
pig model wounds were not infected so no conclusions can be
drawn on the relative value of Opsite and sugar paste for
healing infected wounds.
Conclusion
Sugar paste should be considered for the management of all
infected and malodorous wounds. It is a far less expensive
alternative to Debrisan and similar products which are of
dubious efficacy and are often difficult to remove from
wounds. In our experience, sugar paste is also superior to
charcoal dressings for treating malodorous wounds as it re-
moves the cause of the smell and in this respect is similar
to metronidazole gel. However sugar paste may be preferable
to metronidazole gel for treating such wounds as the use of
topical antibacterials and antibiotics should be
avoided.[10]
Sugar paste lacks the toxicity of most antiseptics and it
does not disrupt the architecture of the healing wounds, as
does packing with gauze.
The paste is self-sterilizing and can be produced in differ-
ent viscosities to suit all kinds of wound and it is not
painful to apply. It may cause bleeding when granulation
tissue is well formed, at which stage simple, non-
impregnated dressings should be applied which will keep the
wound moist and allow epithelialisation to occur.
References
1. Herszage L. et al., Tratamiento de las heridas supuradas
con azucar granulado comercial, Biol Trab Soc Argent., 1980,
41, 315-330.
2. Trouillet J.L., et al., Use of granulated sugar in treat-
ment of open mediastinitis after cardiac surgery, Lancet,
1985, 2, 180-183.
3. Ambrose U. An investigation into the mode of action of
Northwick Park Hospital sugar pastes. Hatfield Polytechnic,
1986, B.Sc. Applied Biology Thesis.
4. Chirife J., et al., In-vitro antibacterial activity of
concentrated polyethylene glycol 400 solutions, Antimicrob.
Ag. Chemother., 1983, 24, 409-412.
5. Wilson C.G. and Thomas N.W. Interaction of tissues with
polyethylene glycol vehicles Pharm. Int., 1984, 5 94-97.
6. Archer H.G. et al., A controlled model of moist wound
healing: comparison between semi-permeable film, antiseptics
and sugar paste. J. exp. Path., 1990, 75, 155-170.
7. Gordon H., et al., Sugar and wound healing Lancet, 1985, 2, 663-664.
8. Chirife J., et al., In-vitro study of bacterial growth
inhibition in concentrated sugar solutions: microbiological
basis for the use of sugar in treating infected wounds, An-
timicrob. Ag. Chemother. 1983, 23, 766-773.
9. Winter G.D. and Scales J.T. Effect of air drying and
dressings on the surface of a wound Nature, 1963, 197,
91-92.
10. Morgan D. Formulary of Wound Management Products (3rd
edition), 1989, Clwyd Health Authority, Preswylfa, Hendy
Road, Mold, Clwyd CH7 1PZ.
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