Infected heel pressure ulcer following hip surgery

An 85-year-old female patient presented with a heel pressure ulcer on her left foot. The ulcer was caused by prolonged immobility following hip surgery and was classified as stage III since the underlying subcutaneous tissue was affected.

  • Products: L-Mesitran Soft and L-Mesitran Tulle.
  • The case study was done by: Georgios E.Papanikolaou, MD PhD, GP Plastic Surgery Private Practice, Ioannina, Greece.
  • Publication: This case report is part of a peer-reviewed case series published in the journal ‘Antibiotics’.

The patient also presented with anxiety, epilepsy, cerebrovascular disease, arterial hypertension, and a vitamin D deficiency. Previous treatment with silver and foam dressings for 10 days was ineffective. Upon first evaluation, the wound dimensions were 5 cm in width and 6 cm in length. The ulcer showed clinical signs of infection, including malodor, a thick and large necrotic eschar, delayed healing, low levels of exudate, and pain. 

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Method with L-Mesitran 

The thick eschar was removed by surgical debridement. L-Mesitran Soft was applied to the wound and followed by L-Mesitran Tulle. The L-Mesitran products were combined with a secondary foam dressing. Wound dressings were performed by the healthcare professional at the patient’s home at 48-hour intervals.

Results after treatment with L-Mesitran

Within 1 week after MGH therapy was started, the malodor disappeared, while the autolytic debridement process was evident. Due to the positive developments of the wound, the dressing changes were transitioned to every 4 days instead of every 2 days. After 4 weeks of treatment with medical grade honey (MGH) products of L-Mesitran, the wound bed was completely clean, granulation and re-epithelialization processes started to show, and the infection was resolved ( week 4). 24 weeks after the start of the treatment with L-Mesitran products the heel pressure ulcer was completely healed without any further complications (week 24).

What is a Heel Pressure ulcer? 

They are one of the most common pressure ulcers and are usually severe due to the vulnerability of the heel. Non-healing heel pressure ulcers have a massive impact on the patient’s quality of life and are often caused by bacterial infections. 

Medical Grade Honey is an effective wound care product, as it simultaneously exerts antimicrobial and wound-healing effects via multiple mechanisms. These multifaceted effects not only contribute to the ability of MGH to treat a broad spectrum of bacteria, but it lacks the risk of resistance.

The antimicrobial effects of MGH rely mainly on the acidic pH, the high osmotic pressure due to the high sugar content, and the release of hydrogen peroxide after the enzymatic breakdown of sugar. In addition to its antimicrobial activities, MGH also promotes wound healing by keeping the wound moist, stimulating autolytic debridement, and exerting anti-inflammatory and anti-oxidative effects.

In this study, the diagnosis of infection was made by clinical assessment of different signs of local infection rather than using wound swabs and subsequent microbial culturing. Swabs can be considered redundant in case of local infections because MGH exerts a broad-spectrum antimicrobial effect; it is expected to resolve the infection independently of the pathogen. On multiple occasions, L-Mesitran products have been reported to successfully treat infected diabetic foot ulcers and pressure sores.

Notably, a bedsore coccyx in an 85-year-old patient was almost completely healed after 32 days of treatment with L-Mesitran. Moreover, L-Mesitran healed extravasation wounds in neonates without complications, highlighting its safety for patients. Another case series reported that L-Mesitran significantly improved heel pressure ulcers in the elderly by removing malodor, promoting debridement, and stimulating granulation.

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Conclusion after treating Heel Pressure Ulcer with L-Mesitran

In conclusion, MGH-based products are clinically and cost-effective for treating hard-to-heal pressure ulcers, such as heel pressure ulcers, and can be proposed as an alternative or complementary to antibiotics and surgery. Furthermore, MGH-based products are easy to apply at home and are cost-effective. This will lead to improving the patient’s quality of life.

More articles about Heel Pressure Ulcers?

We have done more studies about Medical Grade Honey and the positive effects it has on the treatment of Heel Pressure Ulcers.

Are you interested in more cases related to MGH and the treatment of Heel Pressure Ulcers? Click on one of the following articles.