Effects of honey alginate dressings on chronic wounds

Removing barriers timely and proper intervention can be a key to successful wound healing. In normal wound healing process, wounds generally have interfered with various factors such as failure of pressure unloading, nutritional debilitation, bacteria burden, and hemodynamic instability.  Bacterial burden leads to formation of biofilm. Once biofilm is built on wound beds, the healing process get stuck on inflammatory phase chronically. The most recommended method to reduce biofilm is mechanical removal including debridement and vigorous cleansing. However, accompanied pain with procedure is another issue for health care professionals. This poster contains 3 cases of chronic wounds managed by honey-based dressing. The first case was a fungating wound due to breast cancer. Main problem was severe pain during dressings as well as odor and exudate. Wet-gauze dressing with metronidazole powder was not helpful for all symptoms. After gentle saline irrigation, honey-impregnated alginate was applied with hydrofiber and fluffy gauze pad.  Petrolatum-based barrier cream was applied on periwound. Within 2 weeks, we could observe autolysis of necrotic tissue, reducing of bioburden, low score of pain scale, control of foul odor, and epithelialization of wound edge.  Second case was a pressure ulcer on sacrum.  This Stage ll pressure ulcer occurred after operation. Slim and shiny biofilm was observed on the wound bed.  Honey-impregnated alginate and hydrofiber applied with gauze daily for 1 week. As reducing bioburden, autolysis of necrotic tissue and granulation appeared with epithelialization.  Third case was a refractory pressure ulcer occurred 1yr ago.  The patient was on condition of both foot amputations due to diabetics. Antibiotics and topical ointment were not effective. Honey-impregnated alginate with foam dressing was applied. In 2 weeks, clear wound bed appeared and  the edge of wound was shown with proceeding of epithelialization