Treating burnt foot in patient with neuropathy

Products: L-Mesitran Soft, Tulle, and Hydro

Case study performed by: Daniela Chrysostomou, Wound Clinic Health@45, Johannesburg, South Africa.

A 39-year-old male patient presented to the clinic with a full-thickness burn injury to his right foot. The patient suffered from peripheral neuropathy caused by type I diabetes mellitus. He sustained his injury while he was taking a foot bath, as the patient did not realise that the water was too hot due to his peripheral neuropathy. After noticing that his foot was swollen, he sought help and got treated by his general practitioner. The patient received treatment with paraffin gauze, povidone-iodine, and oral amoxicillin and clavulanate, but the wound showed no improvement. Two weeks after the injury occurred he was referred to the wound clinic for treatment with MGH.

L-Mesitran Soft, Tulle, and Hydro were combined with non-woven swabs and zinc paste bandages. Dressings were changed twice a week by the wound care specialist. Upon presentation, the skin was detached from the underlying tissue. 

Clinical signs of a Pseudomonas aeruginosa infection included green exudate and a distinct malodour. Treatment with MGH was started and after 2 days the skin could be removed surgically. 

After one week of MGH treatment, the wound bed showed more healthy granulation tissue. Due to the notable progress observed in the wound after three weeks of treatment, the frequency of dressing changes was reduced from twice a week to once a week.

After one month of treatment initiation, a significant reduction in wound size and redness was observed. Subsequently, after 2 months the wound achieved complete healing, greatly enhancing the patient’s quality of life as reported by the patient himself. He received treatment 12 times in total. Notably, a one-year follow-up examination indicated minimal scarring and almost full restoration of pigmentation.

Comaparing popular burn care products

𝗘𝘃𝗲𝗿 𝘄𝗼𝗻𝗱𝗲𝗿 𝗶𝗳 𝘁𝗵𝗲𝗿𝗲'𝘀 𝗮 𝗯𝗲𝘁𝘁𝗲𝗿 𝘄𝗮𝘆 𝘁𝗼 𝘁𝗿𝗲𝗮𝘁 𝗯𝘂𝗿𝗻𝘀?

Recently published in Burns - Elsevier research by Bouke Boekema et al. has us rethinking burn care! Their paper, 𝘊𝘰𝘮𝘱𝘢𝘳𝘪𝘯𝘨 𝘵𝘩𝘦 𝘢𝘯𝘵𝘪𝘣𝘢𝘤𝘵𝘦𝘳𝘪𝘢𝘭 𝘢𝘯𝘥 𝘩𝘦𝘢𝘭𝘪𝘯𝘨 𝘱𝘳𝘰𝘱𝘦𝘳𝘵𝘪𝘦𝘴 𝘰𝘧 𝘮𝘦𝘥𝘪𝘤𝘢𝘭-𝘨𝘳𝘢𝘥𝘦 𝘩𝘰𝘯𝘦𝘺 𝘢𝘯𝘥 𝘴𝘪𝘭𝘷𝘦𝘳-𝘣𝘢𝘴𝘦𝘥 𝘸𝘰𝘶𝘯𝘥 𝘤𝘢𝘳𝘦 𝘱𝘳𝘰𝘥𝘶𝘤𝘵𝘴 𝘪𝘯 𝘣𝘶𝘳𝘯𝘴, reveals that: ○ 𝗛𝗼𝗻𝗲𝘆 𝗶𝘀 𝗮𝗻 𝗲𝘅𝗰𝗲𝗹𝗹𝗲𝗻𝘁 𝗮𝗹𝘁𝗲𝗿𝗻𝗮𝘁𝗶𝘃𝗲 𝘁𝗼 𝘀𝗶𝗹𝘃𝗲𝗿-𝗯𝗮𝘀𝗲𝗱 𝗽𝗿𝗼𝗱𝘂𝗰𝘁𝘀 ○ 𝗠𝗮𝗻𝘂𝗸𝗮 𝗵𝗼𝗻𝗲𝘆 𝘀𝗵𝗼𝘄𝘀 𝘂𝗻𝗱𝗲𝗿𝗽𝗲𝗿𝗳𝗼𝗿𝗺𝗮𝗻𝗰𝗲 𝗰𝗼𝗺𝗽𝗮𝗿𝗲𝗱 𝘁𝗼 𝗠𝗲𝗱𝗶𝗰𝗮𝗹 𝗚𝗿𝗮𝗱𝗲 𝗛𝗼𝗻𝗲𝘆, 𝗮𝘀 𝘂𝘀𝗲𝗱 𝗶𝗻 𝗟-𝗠𝗲𝘀𝗶𝘁𝗿𝗮𝗻.

Read the full paper

Here

MGH 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(1). 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(2, 3). 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(4, 5).

The MGH rapidly eliminated the signs of the Pseudomonas aeruginosa infection. The wound healed remarkably fast, even though the patient had uncontrolled diabetes. Therefore, MGH can be used as an alternative or complementary treatment for infected burn wounds in diabetic patients.

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References 

  1. Cremers NA. Something old, something new: does medical grade honey target multidrug resistance? J Wound Care. 2021;30(3):160-1.
  2. Mandal MD, Mandal S. Honey: its medicinal property and antibacterial activity. Asian Pac J Trop Biomed. 2011;1(2):154-60.
  3. Almasaudi S. The antibacterial activities of honey. Saudi J Biol Sci. 2021;28(4):2188-96.
  4. Pleeging CCF, Coenye T, Mossialos D, de Rooster H, Chrysostomou D, Wagener F, et al. Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication. Antibiotics (Basel). 2020;9(12).
  5. Smaropoulos E, Cremers NAJ. The pro-healing effects of medical grade honey supported by a pediatric case series. Complement Ther Med. 2019;45:14-8.