Managing Pyoderma Gangrenosum with Leptospermum Honey

Methodology: The patient is a 69 year old male who never missed a day’s work at the shoe factory despite the diagnosis of mylelodysplatic syndrome. He was admitted to our rural hospital two weeks after injuring his right leg while chopping wood. His condition became worse after being treated for cellulitis, s/p incision and drainage procedure. He was transferred to a large metropolitan hospital and was diagnosed with a severe case of Pyoderma Gangrenosum (PG). He was initially treated with high doses of steroids and antibiotics, which stopped the progression of the disease but did not ease the pain. The wound involved his entire lower leg and was covered with yellow slough and eschar. MD orders were to keep the area dry. Initially, Dakin’s soaks were used to keep the wound hydrated and decrease bioburden.  Daily home visits were started by the Home Health agency. Upon sharp debridement at the wound clinic, Leptospermum honey (LH) was ordered due to its antimicrobial and debriding properties and ease of use for the patient and his family.  LH was impregnated into Vaseline gauze and compression wraps were applied. Shortly after the LH was started, heavy rains washed out his lane and the bridge to his home and home health nurses were unable to visit. The family assumed responsibility for wound care with his son, who has a learning disability, being his primary care giver.

Results: After 6 months of treatment with LH wound the wound was fully epithelialized and the pain associated with PG was greatly decreased.

Conclusion:  Despite the severity of his disease and the complexity of the home environment, LH was be administered with successful results. Family members were able to care for  his wound  with confidence and ease, and no adverse effects or complications experienced.