Honning i sår behandling - Oslo universitetssykehus

Honning i sår behandling
Dr Patricia Merckoll
Department of Medical Microbiology, Akershus University Hospital,
Norway.
Background
• Increasing problem with antibiotic resistant
bacteria – MRSA, etc
• Increasing number of wounds : elderly
population, obesity, diabetes, surgery
• Licenced sterile Leptospermum species honey
for wound treatment: Australia, New Zealand,
USA, Canada, Hong Kong, European Union.
Bacteria live in biofilm
Honning v. S. aureus
Minimum Bactericidal
Concentrations
Medihoney
TM
Planktonic
MRSA
3%
Biofilm
embedded
6%
MRSE
3%
6%
ESBL
Klebsiella
Pseudomonas
6%
12%
12%
12%
Merckoll et al. SJID 2009
Why is honey bactericidal?
•
•
•
•
Methylglyoxal
Hydrogen peroxide
Sugar
Phenolic compounds including flavonoids,
(directly reflecting the floral source of the
nectar),
• Acids, minerals.
What does honey actually do to
the bacteria?
Publications : June-October 2009
• S.aureus fails to divide
Henriques et al Eur J Clin Microbiol Infect Dis Oct 2009
• Fatty acid synthesis downregulated
Jenkins et al Soc. Gen Microbiol Sept 2009
• Protein synthesis is downregulated
• Stress response switched on
• No development of resistance
Blair et al Eur J Clin Microbiol Infect Dis June 2009
• What happens to biofilm
production/structure?
Published reports of effects of
honey on wound healing
• Antibacterial
• Deodorising of wound
• Reduced pain, exudate and swelling
• Recruitment and activation of immune cells to wound
• Osmotic action – moist wound healing, easy dressing changes
• Debridement – removal of necrotic tissue and debris
• Stimulation of tissue growth- angiogenesis, increased granulation
tissue, increased collagen production, reduced scarring
Dag 1: Brannskade. 3 måneder.
Dag 12
Dag 1. Hud transplantasjon (3 måneder).
Dag 14
Diabetisk fotsår. 7 måneder
Dag 1-14 Honning behandling
Dag 1. Kronisk sår
Dag 9
Dag 40
Dag 1. Liggesår. 1 år
Dag 3
Dag 8
Dag 1-8
Operasjonssår, achilles, 5 mnd.
Dag 1-5
Might reintroduction of honey in
woundcare improve healing times and
reduce antiobiotic use in Norway?
Takk
•T-Ø Jonassen, ME Vad,
Prof. SL Jeansson, Prof KK Melby
•MIKA, KOPRO, UUS
•UUS Medisinsk Biblioteket
• Akershus Universitetssykehus
Mikrobiologi Avd. og Epigen Avd
•Prof Dag Berild, Dee Berg
•Aksel og Lily Merckoll