Autolytic Debridement with L-Mesitran on a Necrotic Wound

An 89 year old female had an abrasion on her left leg due to a
traffic accident. She had previously taken oral steroids which
induced thinning of the skin. The wound was 3 weeks present
before being presented to the hospital. During that period,
the wound was only treated with topical antibiotics.

The wound size was 7×3 cm and it was covered with necrotic tissue, indicating critical colonization of the wound. An option of treatment was sharp debridement, but in this case, (considering the thin skin of the patient and the lack of response  to antibiotics), a less invasive method of autolytic debridement
with honey based preparations was preferred.

The patient was treated daily on an outpatient basis. The wound
were cleaned with saline; the honey based ointment was applied
thinly on the wound (on the necrosis) and then covered with a
soft silicone dressing. No additional antibiotics were used.

After 3 days of treatment, the necrotic tissue was already
weakened and fell off, showing that granulation was in progress.
The wound edges were firm; no inflammation visible. After 10 days of treatment, the wound were clinically

The patient did not experience any pain nor were any adverse effects observed. This auto-debridement method is less invasive and is, therefore, less stressful for the patient and more cost effective .