70 Year Old Patient with Cranial Wound After Removal of Basal Epithelioma

A 70 year old woman showed basal cell epithelioma on top ofher head. Epithelioma can be described as a rapid local growth of epithelium and can either be benign or malignant. They can be removed with topical immunotherapy, photodynamic therapy, radiotherapy, but in most cases surgical removal is safe when enough margins are available around the defect.

In this case, surgery was performed to remove the malignant epithelioma and perform a partial convergence of the wound. All the excess tissue growth was removed, leaving an open wound measuring ± 8cm x 4.6cm and 0.5cm deep.

The wound was treated with povidone iodine 10% solution and fusidic acid paraffin gauze for a week after the surgery. Unfortunately, necrotic tissue developed with high exudates and malodour. This led to a change in wound management to medical grade honey products as they have proven in the past in the hospital to be useful. 

The expectation now was that it would remove the malodour and start granulation in the wound bed. The patient did not receive any other medications that might be of influence on wound healing.

At the start of the honey treatment, the wound was very wet, malodorous and necrotic. The wound was cleaned with saline. Then, it was covered with the honey mesh (L-Mesitran Net) on top of which the medical grade honey gel was applied (L-Mesitran Soft).

On top of this, a calcium alginate dressing was placed and fixed by a sterile adhesive dressing. Dressing changes were done every other day. After only eight days the malodour was gone. The necrotic tissue was softened and removed.  Eight days later, the lesion showed marked granulation and its size was reduced by 50%.

Throughout the course of treatment, the wound closed without any adverse effects and it completely healed in two months. The dressings were easy to apply without damaging newly formed delicate tissue. The dressing changes were done by the physician at the patient’s home. At the 6 months follow up, the epithelioma had not returned.