Healing clinically complex wounds in a cancer treatment center using active leptospermum honey

Purpose/Clinical Problem:

Simultaneous treatment of wounds in oncologic patients is a complex clinical decision making process. Many advanced wound care treatments are contraindicated in these patients. These wounds often become “chronic” and fail to move through the reparative process in an orderly fashion. (ref 1) Patients with compromised immune systems secondary to cancer or other diseases can have failure in the inflammatory phase of healing, due to lack of cytokine regulation. Active leptospermum honey (ALH) stimulates cytokine induction from human monocytes. (ref 2)  These patients are often dealing with high levels of pain that are difficult to manage without narcotics.

Case Discussion:

6 patients with varying wound/integumentary issues were treated using a variety of ALH dressings after failure to heal with traditional wound care. Age range: 39-64, 5 female & 1 male, most had 2-3 comorbidities in addition to cancer diagnosis, chronic wounds included surgical sites, radiation dermatitis and tumor presence. 4 of 6 were treated with a new hydrogel colloidal sheet  impregnated with ALH. 2 were treated with ALH gel and absorbent dressings or negative pressure therapy for excessive exudates.  All patients/wounds exhibited signs of decreased inflammatory response, increase in healthy tissue or wound closure and decreased pain.

Conclusion:

Using ALH in a variety of available forms, as the primary advanced wound dressing for these clinically complex patients resulted in improved healing times, final closure and decreased pain. These findings are consistent with Robson & Cooper (2009) and Simon, et al (2006) whose studies included use of ALH in oncologic patients including pediatrics. (ref 3 & 4) Use of these advanced dressings in this patient population improved quality of care and warrants further research to be considered as a first line dressing choice.