The impact of Manuka honey dressings on the surface pH of chronic wounds

International Wound Journal - Tập 5 Số 2 - Trang 185-194 - 2008
Georgina Gethin1, Seamus Cowman2, Ronán Conroy3
1Research Centre, Faculty of Nursing and Midwifery, Royal College of Surgeons, Ireland (RCSI), Dublin, Ireland.
2S Cowman, Professor, PhD, MSc, Faculty of Nursing and Midwifery, Royal College of Surgeons, Ireland (RCSI), Dublin, Ireland
3RM Conroy, DSc, Associate Professor of Biostatistics, Royal College of Surgeons, Ireland (RCSI), Dublin, Ireland

Tóm tắt

AbstractChronic non healing wounds have an elevated alkaline environment. The acidic pH of Manuka honey makes it a potential treatment for lowering wound pH, but the duration of effect is unknown. Lowering wound pH can potentially reduce protease activity, increase fibroblast activity and increase oxygen release consequently aiding wound healing. The aim of this study was to analyse the changes in surface pH and size of non healing ulcers following application of Manuka honey dressing after 2 weeks. The study was an open label, non randomised prospective study. Patients presenting consecutively with non healing chronic superficial ulcers, determined by aetiology and no reduction in wound size in previous 3 weeks. Single pH measurements recorded using Blueline 27 glass surface electrode and R 315 pH meter set (Reagecon/Alkem, Co. Clare Ireland). Area determined using Visitrak (Smith & Nephew, Mull, UK) digital planimetry. Apinate® (Manuka honey) (Comvita, Slough, UK) applied to wounds for 2 weeks after which wounds re‐evaluated. Eight males and nine females with 20 ulcers (3 bilateral) were included: venous, 50% (n = 10); mixed aetiology, 35% (n = 7); arterial, 10% (n = 2) and pressure ulcer, 5% (n = 1). Reduction in wound pH after 2 weeks was statistically significant (P < 0·001). Wounds with pH ≥ 8·0 did not decrease in size and wounds with pH ≤ 7·6 had a 30% decrease in size. A reduction in 0·1 pH unit was associated with an 8·1% reduction in wound size (P < 0·012). The use of Manuka honey dressings was associated with a statistically significant decrease in wound pH and a reduction in wound size. Elevated pH readings at the start were associated with minimal reduction in size. Surface wound pH measurements may contribute to objective wound assessments, but further research is necessary to determine its exact contribution.

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Tài liệu tham khảo

10.1016/S0305-4179(97)00113-7

10.1046/j.1365-2672.2002.01761.x

10.1111/j.1742-4801.2005.00078.x

10.1681/ASN.2004110997

10.1089/acm.2005.11.511

Jull AB, 2006, 16th Conference of European Wound Management Association; 2006, 48

10.1177/1534734605286014

10.1002/bjs.1800750718

10.1080/0005772X.1999.11099430

10.1111/j.1067-1927.2005.1304S1.x

Melhuish J, 1993, Proceedings of the 3rd European Conference on Advances in Wound Management; 1993, 41

Ganong WF, 2001, Review of medical physiology

Solomon E, 1990, Human anatomy and physiology

Stacy M, 2000, Chronic wound healing clinical measurement and basic science, 99

10.1046/j.1524-475x.2000.00264.x

Wilson M, 1979, The pH of varicose ulcer surfaces and its relationship to healing, VASA, 8, 339

Roberts G, 1997, Proceedings of the 7th European Conference on Advances in Wound Management; 1997 Nov 18–20, 104

Romanelli M, 1997, Evaluation of surface pH on venous leg ulcers under Allevyn dressings

10.1097/00000658-197312000-00011

10.1016/0305-4179(85)90032-4

Tsukada K, 1992, The pH changes of pressure ulcers related to the healing process of wounds, Wounds Compend Clin Res Pract, 4, 16

Hunt TK, 2005, The wound management manual

Thomas S, 1990, Functions of a wound dressing in: wound management and dressings

Romanelli M, 1997, Objective measurement of venous ulcer debridement and granulation with a skin colour reflectance analyzer, Wounds, 9, 122

Molan P, 2002, Re‐introducing honey in the management of wounds and ulcers – theory and practice, Ostomy Wound Manage, 48, 228

Romanelli M, 2002, Technological advances in wound bed measurements, Wounds, 14, 58

Brett D, 2003, Wound pH: a historic review of topical enzymatic debridement

10.12968/jowc.2005.14.2.26739

10.1016/S0039-6109(05)70570-3

Sheffield P, 1988, Problem wounds the role of oxygen

Morykwas M, 1997, Nonsurgical modalities to enhance healing and care of soft tissue wounds, J South Orthop Assoc, 6, 279

Green J, 1978, Basic clinical physiology

10.1046/j.1524-475X.1999.00442.x

10.12968/jowc.1999.8.6.25885

10.1046/j.1524-475X.2002.10510.x

10.12968/jowc.2004.13.9.26708

10.12968/jowc.1996.5.6.277

10.1016/S1561-5413(09)60055-7

10.1016/0140-6736(92)92483-V

10.1016/S0140-6736(68)90004-4

10.12968/jowc.1999.8.4.25867

10.1177/014107689909200604

Molan P, 1998, A brief review of the use of honey as a clinical dressing, Prim Intention, 6, 148

PercivalS BowlerP.Understanding the effects of bacterial communities and biofilms on wound healing.World Wide Wounds(http://www.worldwidewounds.com)2004.

10.1046/j.1365-2133.2000.03478.x

10.1016/S0002-9343(00)00379-X

10.1111/j.1742-4801.2006.00178.x

10.12968/jowc.2003.12.5.26493

Dunford C, 2000, Using honey as a dressing for infected skin lesions, Nurs Times, 9, 7

10.1128/AAC.23.5.766

10.1016/S0965-206X(00)80036-4

10.12968/jowc.1996.5.10.444

10.12968/jowc.2005.14.7.26813

Himel H, 1995, Wound healing: focus on the chronic wound, Wounds, 7, 70

10.12968/jowc.1995.4.6.269

Tallman P, 1997, Initial rate of healing predicts complete healing of venous ulcers, Arch Dermatol, 133, 1231, 10.1001/archderm.1997.03890460053006

10.1111/j.1365-2702.2006.01364.x

Mani R, 2000, Chronic wound healing, 136

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International Wound Journal

Tập 5 Số 2

185-194

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