Medical-Grade Honey (MGH) was found to be a safe and effective treatment for extravasation-induced injury in a preterm neonate, promoting significant wound healing progress and suggesting its potential value as a treatment option in this vulnerable patient population.
A preterm twin female infant (32 weeks of gestation) with a birth weight of 1350 g was admitted to the NICU right after her delivery due to pulmonary deficiency. On the fifth day of her life, she presented symptoms of necrotizing enterocolitis. The diagnosis was confirmed, and TPN and conservative treatment were started. During the night shift on the eleventh day of her life, a venous line was misplaced and created a severe ischemic injury due to extravasation of TPN, located at the left forearm. The hand was extremely edematous, and the presence of blisters on the skin proximally to the lesion supported signs of ongoing inflammation. Both venous and arterial network was severely affected as confirmed by Doppler ultrasound, and a fasciotomy was compulsory to relieve pressure and save the forearm.
Infant Patient Profile
Product: L-Mesitran Ointment
Case study done by: E. Smaropoulos, MD, PhD (Hippokration General Hospital, Thessaloniki, Greece) e-mail address: lsmaropoulos@gmail.com
Method: The extravasation-induced injury was treated with daily Medical-Grade Honey (MGH) monotherapy and closely monitored.
After fasciotomy, monotherapy with MGH was started and applied once a day. Further surgical debridement was performed the next day in addition to the treatment with MGH. After eight days, the wound presented necrotic tissue limited to the borders, which was scrubbed using saline-wetted gauze to remove the created biofilm.
After eleven days of MGH treatment, edema had markedly been reduced, the wound did not show any signs of infection, and epithelialization was clearly noticeable. MGH treatment was continued, and healing was almost completed 48 days after the fasciotomy was performed. In the final stages of healing (day 60), the wound was covered with silicon to prevent hypergranulation.
After only 67 days of MGH treatment, the wound healed completely with an acceptable cosmetic result.
Discussion on effects of Medical-Grade Honey (MGH)
- Preterm neonates (before 37 weeks of gestation) are often small and not fully developed. Therefore they are at risk for morbidities and are in need of medical attention.
- They often get a peripheral intravenous catheter placed to provide fluid, nutrition (TPN), and medication. Since the skin of these neonates is not fully developed and is very delicate, these babies have increased the risk to develop extravasation-induced injuries (1, 2). Evidence-based treatment strategies are lacking, and therefore, we investigated the use of MGH to improve extravasation-induced wound repair in this highly vulnerable patient group (3).
- MGH therapy was very well tolerated by this highly delicate preterm neonate and did not demonstrate any sensation of pain due to the application or use of MGH.
Conclusion
Medical-Grade Honey (MGH) was found to be a safe and effective treatment for extravasation-induced injury in a preterm neonate. The treatment went well with significant wound healing. Based on this Case Study, MGH may be a valuable treatment option for extravasation injuries in this vulnerable patient population profile.