Novel use of Leptospermum honey for pin site care

Purpose:  A single center case series to investigate the safety and efficacy of active Leptospermum honeycolloids *(ALH) for use in pin site care after open reduction external fixation (OREF) of DM Charcot patients undergoing reconstruction.

Background: The use of OREF in the DM population has a high incidence of pin site sepsis with standard treatments.  Historically this has consisted of once or twice daily saline and peroxide cleanses with dry gauze dressing.  Medihoney would be a useful product to have for pin site care after OREF that allows for adequate absorption, less frequent dressing change, good safety profile, antibacterial affect and cost effectiveness.

Methodology: Five patients undergoing OREF for DM Charcot reconstruction had ALH applied to pin and wire sites intraoperatively and then changed weekly following a cleanse with peroxide for up to 8 weeks.  Documentation of sepsis was noted based on clinical findings of the cardinal signs of infection including calor, dolor, erythema, inflammation, and increasing exudates. 

Results:  Only two wire sites were noted to have signs of infection out of a total of 57 sites on five patients.  These two sites resolved uneventfully with a short course of empirical antibiotics administered by mouth. 

Conclusions:  Weekly application of ALH may be considered a safe, lower-cost, less cumbersome and more efficacious agent for use in this patient population.   Further large study is indicated.