The Efficacy of "MediHoney" to Facilitate Catheter Exit-Site Surgical Wound Healing
| Status: | Terminated |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 18 - 90 |
| Updated: | 8/19/2018 |
| Start Date: | January 2011 |
| End Date: | November 28, 2016 |
The Efficacy of "MediHoney" to Facilitate Catheter Exit-Site Surgical Wound Healing and Prevention of Wound Bacterial Colonization: A Randomized, Open-label, Controlled, Clinical Trial
To evaluate the efficacy of honey as a post surgical exit site care process to promote
healing and prevent infectious bacterial colonization of newly created exit sites. It has
been shown in the medical literature that honey has properties that are conducive to healing
and the prevention of infection. In one study it was demonstrated that in urethral injury in
the rat treated with honey the injury healed with none of the usual formation of fibrous
tissue seen in such healing processes, that there was no reduction in the luminal diameter
usually seen, and that the cells lining the urethra were uncompromised in any way, i.e.
totally normal and healthy. We feel that if an exit site can be healed quickly with good
normal tissue being developed that the patient will have a much better chance to keep that
exit healthy reducing time, cost, and disruption of lifestyle. Other positive aspects of
honey are it has the low pH required for good healthy tissue healing, it works in the
presence of wound fluids, and it has never been shown to produce a resistant bacterial
strain.
healing and prevent infectious bacterial colonization of newly created exit sites. It has
been shown in the medical literature that honey has properties that are conducive to healing
and the prevention of infection. In one study it was demonstrated that in urethral injury in
the rat treated with honey the injury healed with none of the usual formation of fibrous
tissue seen in such healing processes, that there was no reduction in the luminal diameter
usually seen, and that the cells lining the urethra were uncompromised in any way, i.e.
totally normal and healthy. We feel that if an exit site can be healed quickly with good
normal tissue being developed that the patient will have a much better chance to keep that
exit healthy reducing time, cost, and disruption of lifestyle. Other positive aspects of
honey are it has the low pH required for good healthy tissue healing, it works in the
presence of wound fluids, and it has never been shown to produce a resistant bacterial
strain.
The exit site (ES) of any transcutaneous device, or foreign body, through the skin presents
as the site most vulnerable in terms of device survival. With the large numbers of catheters
in use in chronic dialysis today exit-site care for the prevention of infection is of
critical importance in reducing morbidity and mortality. Pericatheter infection is the number
one cause of catheter loss in peritoneal dialysis patients.
It appears that honey is a compound with a multi-factorial mode of action. It is thought that
with most honeys, the antimicrobial action stems from its high osmolality and the fact that
it produces continuous non-cytotoxic levels of hydrogen peroxide due to enzymatic break down
of the sugar. Honey also has a low pH which is not conducive for most bacterial growth but is
good for wound healing.
Observational reports have shown some success in healing infected wounds, ulcers, protection
of plastic surgery transplants, burns, herpetic skin lesions, and atopic dermatitis. Honey
has also been shown to have antimicrobial action against a broad spectrum of fungi and
bacteria including antibiotic resistant bacteria. Another study reports that honey reduces
inflammation, edema, and promotes angiogenesis.
In an animal study of urethral injury it was shown that contrary to controls, there was a
total healing with restoration of normal urethral epithelium and connective tissue with
complete absence of fibrosis and inflammation. There was also no narrowing of the lumen as
seen in the other study groups.
A study of prophylactic exit-site care of hemodialysis catheters comparing honey and
Mupirocin demonstrated that results with honey were comparable to that of Mupirocin. However,
unlike Mupirocin, there has not been an emergence of honey-resistant bacterial strains which
makes it an attractive alternative agent.
as the site most vulnerable in terms of device survival. With the large numbers of catheters
in use in chronic dialysis today exit-site care for the prevention of infection is of
critical importance in reducing morbidity and mortality. Pericatheter infection is the number
one cause of catheter loss in peritoneal dialysis patients.
It appears that honey is a compound with a multi-factorial mode of action. It is thought that
with most honeys, the antimicrobial action stems from its high osmolality and the fact that
it produces continuous non-cytotoxic levels of hydrogen peroxide due to enzymatic break down
of the sugar. Honey also has a low pH which is not conducive for most bacterial growth but is
good for wound healing.
Observational reports have shown some success in healing infected wounds, ulcers, protection
of plastic surgery transplants, burns, herpetic skin lesions, and atopic dermatitis. Honey
has also been shown to have antimicrobial action against a broad spectrum of fungi and
bacteria including antibiotic resistant bacteria. Another study reports that honey reduces
inflammation, edema, and promotes angiogenesis.
In an animal study of urethral injury it was shown that contrary to controls, there was a
total healing with restoration of normal urethral epithelium and connective tissue with
complete absence of fibrosis and inflammation. There was also no narrowing of the lumen as
seen in the other study groups.
A study of prophylactic exit-site care of hemodialysis catheters comparing honey and
Mupirocin demonstrated that results with honey were comparable to that of Mupirocin. However,
unlike Mupirocin, there has not been an emergence of honey-resistant bacterial strains which
makes it an attractive alternative agent.
Inclusion Criteria:
- Patients requiring dialysis due to loss of kidney function
- Patients choosing Peritoneal Dialysis (PD) for treatment
- All PD patients having an indwelling PD catheter placed
Exclusion Criteria:
- Patients younger than 18 years of age
- Prisoners
- Patients with mental defect
- Veteran Administration patients
We found this trial at
1
site
1 Hospital Drive
Columbia, Missouri 65201
Columbia, Missouri 65201
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