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The Australian Bee population is about to triple in size I think???
Does anyone use or have experience of the new Medihoney just been made available through NHS Logistics Authority, and I assume to private practise, too, for wounds! Or is this directed at our nurses bearing in mind they have the main care for treating wounds on legs in general practise!
I have experience in the use of English honey but the Australian Bees seem to have a much better, (stronger?), honey for wound healing!
Regards,
Colin.
Last edited by C Bain : 22nd March 2005 at 05:00 PM.
we don't use medihoney here, partly due to cost, and partly due to lack of evidence in the treatment of diabetic foot wounds.
We did use some samples, and did find it a bit messy, but no patient issues. Its best use would be for the chronic infected type wounds, but its benefits over silver dressings and Iodosorb are not established
The medihoney is a Manuka honey, from the Manuka bush, a native NZ plant, but also grown in Australia. You can spread it on your toast, but it is a bit bitter.
New Zealands Waikato University has a honey institute which did most of the R&D around honey as an antiseptic and wound dressing.
Thank you for that information on Manuku honey. Strange that in all the papers I have read on it over the past eighteen months none have mentioned that it's from a bush not a bee?
Agreed about the link with diabetic foot wounds, (Another possible unknown at this time?). My information comes mainly from a journal I receive on wound care. It is directed at nurses and in some cases written by them in the UK dealing with wounds on legs and a few other embarrassing places!
Free access to the product has been zero on the open market until possibly now over here, ref. application.
Regards,
Colin.
P.S. Well I suppose if Australia can have hopping kangaroos, New Zealand can have flying honey bushes!
hi guys i have been searching the web for articles on manuka honey and its use on diabetic wounds... i know it works but just need some evidence its ok to use on dm patients Cheers tash
I try it on patients who want it to work and give them a few weeks for any improvement, but unfortunately I haven't had any good results so far. I'd like it to be effective, as it is a natural product, but I find it only works on patients who are going to heal regardless of which product you use.
For those interested in wether it is appropriate to use honey on diabetic wounds considering they are diabetic and dressing is honey if you get my meaning check this article out... hope it works
Hi Everyone,
I have used Manuka Honey on some patients with minor skin lesions with mixed success. It seems to work well on some. I used a medicinal quality dressing from a company called "Advancis". Their info notes : Whilst many claims are being made for the therapeutic benefits of active Leptospermum Honey's (eg Manuka and Jelly Bush) these and other varieties of honey are still awaiting clinical evaluation to determine the full extent of the therapeutic benefits.
Also...a note on DM patients.: although there has been no reported incidence of increased levels of sugar in the bloodstream due to the use of honey in wounds, it is advisable to monitor the blood sugar levels of diabetic patients.
I used "Activon tulle"....which is a non-adherent wound dressing impregnated with Manuka honey.
You can check out the company website at www.advancis.co.uk
regards,
Leigh
Press Release: UW STUDY TESTS TOPICAL HONEY AS A TREATMENT FOR DIABETIC ULCERS
5/2/2007
Quote:
EAU CLAIRE, WI-The sore on Catrina Hurlburt's leg simply wouldn't heal.
Complications from a 2002 car accident left Hurlburt, a borderline diabetic, with recurring cellulitis and staph infections. One of those infections developed into a troublesome open sore that, despite the use of oral antibiotics, continued to fester for nearly eight months.
Then Hurlburt's physician, Jennifer Eddy of UW Health's Eau Claire Family Medicine Clinic, suggested she try using topical honey.
Within a matter of months, the sore had healed completely.
"I remember thinking, holy mackerel-what a difference," says Hurlburt, who can't use topical antibiotics because of allergies. "It's a lot better than having to put oral antibiotics into your system."
With funding provided by the Wisconsin Partnership Fund for Health and the American Academy of Family Physicians Foundation, Eddy is currently conducting the first randomized, double-blind controlled trial of honey for diabetic ulcers. Eddy first successfully used honey therapy a few years ago with a patient who was facing amputation after all medical options had been exhausted.
Experts believe that treating wounds with honey has tremendous potential for the approximately 200 million people in the world with diabetes, 15 percent of whom will develop an ulcer, usually because of impaired sensation in their feet. Currently, every 30 seconds someone somewhere in the world undergoes amputation for a diabetic foot ulcer. In 2001, treating diabetic ulcers and amputations in U.S. patients cost $10.9 billion.
"Patients like Catrina Hurlburt are a great example of the potential health care savings," explains Eddy, who is also assistant professor of family medicine at University of Wisconsin School of Medicine and Public Health. "Unsuccessful conventional care for ulcers can cost thousands of dollars. Therapy with honey may only cost a few hundred."
Diabetics typically have poor circulation and decreased ability to fight infection. Diabetic ulcers treated with long courses of systemic antibiotics can become colonized with drug-resistant organisms-so-called "superbugs" such as Methicillin-resistant Staphylococcus aureus (MRSA). Since honey fights bacteria in numerous ways, it is essentially immune to resistance. Honey's acidic pH, low water content (which effectively dehydrates bacteria), and the hydrogen peroxide secreted by its naturally-occurring enzymes make it ideal for combating organisms that have developed resistance to standard antibiotics.
"This is a tremendously important issue for public health," explains Eddy, adding that the Centers for Disease Control and the World Health Organization have identified bacterial resistance as one of the most important medical problems of our day.
Patients in the clinical trial will receive ulcer care and treatment by an expert podiatrist. Half will be randomly assigned to receive honey, while the other half will receive a wound-care gel that has been compounded with inert components to give it the flavor and color of honey. The ulcers will be measured to see how quickly they heal, to evaluate whether honey or the standard wound gel is better for healing.
If honey proves the more effective method, Eddy cautions patients against using it at home without a physician's involvement. "Unfortunately, diabetic ulcers are very complicated, and honey would only be part of the solution," she says. Successful care also requires off-loading-avoiding walking and putting weight on the sore-and the sterile removal of dead skin and bacteria from the wound.
"If we can prove that honey promotes healing in diabetic ulcers, we can offer new hope for many patients," says Eddy. "Not to mention the cost benefit, and the issue of bacterial resistance. The possibilities are tremendous."
If Hydrogen Peroxide is the pharmaceutical compound that is produced by medihoney, why not use Crystacide. I use it regularly when infection presents and am quite impressed at how effective it is.
Derma Sciences, Inc. (Princeton, NJ) recently received clearance from the Food and Drug Administration (FDA) to market and sell its API-MED™ Active Manuka Honey Absorbent Dressing. This represents the first FDA clearance of a honey-based product for the management of wounds and burns.
After attending an all day lecture by Dr Molan on the benefits of honey I have trialled it in the clinic on both diabetic and non diabetic patients with foot ulceration.
The product is Apinate from Comvita (NZ), it is an alginate impregnated dressing so has some exudate absorbency properties as well as the antimicrobial.
Patients have in general been happy with application only a few complaining that it stung. I feel it has limited application on planter ulceration as it tends to move around too much even under secondary dressings and padding, have also trialled under TCC, once again too much movement resulting in shear.
Seems to work best on leg wounds, will remove slough resonably well and is another weapon in the arsonal. Given the choice of silver or honey I would still choice silver .
The latest OWM has the full text of this: Honey and Contemporary Wound Care: An Overview
Quote:
A growing body of research and empirical evidence have supported the re-discovery of medicinal grade honey as a wound management agent. Pre-clinical study results suggest that honey has therapeutic benefit; clinical study results have shown that honey effectively addresses exudate, inflammation, devitalized tissue, and infection. Honey-containing dressings and gels have been developed to facilitate the application of medicinal-grade honey to the wound. Clinical studies to compare the safety and effectiveness of these products to other moisture-retentive dressings and treatment modalities are warranted.
ScienceDaily are reporting: Treating Venous Leg Ulcers With Honey Dressings Unlikely To Help Healing
Quote:
When compared with normal care, treating a leg ulcer with dressings impregnated with honey did not significantly improve the rate of healing, but did lead to a significantly increased number of reported adverse events, according to research published today in the British Journal of Surgery.
The breakdown in skin tissue below the knee that ends in venous leg ulcers forming has been recognised for centuries. Since the 17th century it has been treated by applying a compression bandage and we now know that this helps the leg cope with the constant pressure of fluids in lower parts of the body (hydrostatic pressure).
The current interest in alternative medicines has led to renewed interest in honey as a potential healing agent, and some people have suggested using honey dressings as well as a compression bandage.
In a trial run in four centres around New Zealand (Auckland, South Auckland, Waikato and Christchurch), 368 patients were randomly divided into two groups. One was given conventional dressings, the other was given dressings impregnated with honey. Both groups had compression bandaging. After 12 weeks there was no significant difference between the rates of healing in the two groups. However, the honey treatment was more expensive, and people in that group reported significantly more adverse events than in the conventional group (111 vs 84 P=0.013).
"In our trial the honey dressing did not significantly improve healing, time to healing, change in ulcer area, incidence of infection or quality of life," says lead author Dr Andrew Jull who works in the Clinical Trials Research Unit at the University of Auckland.
"The current focus of venous ulcer management should remain on compression and other treatments that have demonstrated that they improve compression's ability to work or prevent ulcer recurrence," says Dr Jull.
Press Release: Derma Sciences Announces Clinical Poster on Use of MEDIHONEY(TM) Wound & Burn Dressings Wins First Place Award at APWCA
Quote:
PRINCETON, N.J., March 20 / -- Derma Sciences,
Inc. (OTC Bulletin Board: DSCI), provider of advanced wound care products,
announced today that one of the four abstracts detailing the clinical usage
of its newly released MEDIHONEY(TM) Wound & Burn Dressings with Active
Leptospermum Honey presented at the annual American Professional Wound Care
Association (APWCA) conference held the second week in March in Forth
Worth, Texas, was awarded first prize in the association's review of all
posters presented. The poster, titled "Chronic Lower Extremity Ulceration
-- Use of a Leptospermum Impregnated Alginate to Accelerate Wound Closure,"
was presented by Dr. Matt Regulski, DPM, Toms River Foot and Ankle Surgical
Associates, New Jersey. The poster, selected by a multidisciplinary group
including a podiatrist, a vascular surgeon, and a wound care certified
nurse, was one of 40 posters accepted at this year's conference.
There are over 1 million patients with non-healing leg ulcers each year
in the US. That number is growing along with the aging of the population.
It has been estimated that the average total cost of care to manage a
non-healing leg ulcer is roughly $10,000. Costs can increase dramatically
if surgical interventions are required. Dr. Regulski's study looked at 8
patients he had been treating that had non-healing venous leg ulcers. All
patients had been managed with multi-layer compression along with another
advanced wound care dressing to cover the wound. The study design had a
typical 12-week evaluation period, standard in protocols that look to
quantify the complete 100% healing rate. The same multi-layer compression
was continued, but the wound dressing covering the wound was changed to
MEDIHONEY. After only 6 weeks, five of the wounds had completely closed,
and the other three wounds averaged 75% closure by the end of the study
period. This resulted in a combined 91.4% closure rate. Additional
endpoints quantified during the study included:
-- Decreased pain
-- Decreased inflammation
-- Decreased edema
-- Increased management of wound fluid
-- No increase in blood sugar levels in the five diabetic patients
enrolled
About the product's recognition at the APWCA, CEO Edward Quilty said,
"Venous leg ulcers can be some of the most difficult to manage. Although
50% heal with standard multi-layer compression therapy, it is the other 50%
that make the quality of life so poor for patients with this type of ulcer.
We knew from Georgina Gethin's large-scale randomized controlled study
presented last year that the use of Active Leptospermum Honey helped to
increase the healing rate of these otherwise non-healing leg ulcers, and we
sought to do a confirmatory case series study when we launched MEDIHONEY
last fall. Dr. Regulski's study is impressive and compares very favorably
to other case series of 8-12 non-healing leg ulcer patients managed with
other products. Indeed, as is the case with any new product introduced into
the wound care market, clinicians first put the dressings on their toughest
hard-to-heal wounds, and the majority of MEDIHONEY used so far has been on
these non-healing leg ulcers. This is exciting to us for two reasons:
First, we believe that the reputation MEDIHONEY is garnering out in the
field for its effectiveness on non-healing leg ulcers is helping to
position the product as first-line for this type of ulcer by the clinicians
that have used the dressing. As word spreads and as we increase our sales
force, the product stands a good chance of widespread adoption for the
management of non-healing leg ulcers. Secondly, since this type of wound is
third in incidence within the big three ulcer types -- behind pressure
ulcers and diabetic foot ulcers -- we have good reason to believe that our
initial strong sales are only scratching the surface of what we will be
able to achieve with MEDIHONEY. We have larger cohort studies planned for
both diabetic foot ulcers and pressure ulcers, and based on the evidence we
have seen thus far to date on these types of ulcers, we are confident that
we will see similar movement towards first-line positioning in the
management of these wounds."
Speaking of his use of MEDIHONEY, Dr. Matt Regulski said, "Because of
its capability as a debrider, anti-inflammatory, free-radical absorber,
odor fighter, and properties for fibroblast and macrophage enhancement,
this dressing is incredibly versatile and cost-effective. It takes the
place of two or three dressings which saves money, and it is very easy to
apply. Patients love the idea of a natural dressing instead of applying
synthesized chemicals to their wounds. This marks our return to more
natural treatments with proven efficacy. Its popularity is only going to
grow. We have had great success with it, and it is a part of our everyday
treatment regimen for all of our patients."
Safety and efficacy of a new honey ointment on diabetic foot ulcers: a prospective pilot study.
Abdelatif M, Yakoot M, Etmaan M. J Wound Care. 2008 Mar;17(3):108-10.
Quote:
OBJECTIVE: To study the effectiveness and safety of PEDYPHAR ointment (a new ointment prepared from natural royal jelly and panthenol in an ointment base) in the treatment of patients with limb-threatening diabetic foot infections.
METHOD: Sixty patients presenting with limb-threatening diabetic foot infection were categorised into three groups, based on the severity of the lesions. Group I: full-thickness skin ulcer (Wagner grades 1 and 2); group 2: deep tissue infection and suspected osteomyelitis (grade 3); group 3: gangrenous lesions (grades 4 and 5).They were treated with PEDYPHAR ointment after irrigation and cleansing with normal saline, and surgical debridement if required.The lesions were covered with dressings and patients were followed up for six months or until full healing occurred. No other specific treatment was given apart from insulin treatment to control the diabetes.The primary endpoint was the clinical response at weeks 3, 9 and 24 from the start of treatment.
RESULTS: Ninety-six per cent of the patients in groups 1 and 2 responded well, with a complete cure, defined as'complete closure of the ulcer without signs of underlying bone infection' by the end of week 9 and for the duration of the six-month follow-up period. All of the ulcers in group 1 healed, as did 92% of those in group 2. All patients in group 3 healed following surgical excision, debridement of necrotic tissue and conservative treatment with PEDYPHAR ointment.
CONCLUSION: We can conclude from our pilot study that PEDYPHAR ointment may be a promising, safe conservative local treatment. However, further double-blind randomised controlled studies are needed to confirm this.
Press Release: New Study Shows the Use of MEDIHONEY(TM) Wound & Burn Dressing is Associated With Reduction in Wound Size
International Wound Journal article cites pH modulation as a key method of action
Quote:
PRINCETON, N.J., April 8, 2008 Derma Sciences
Inc (OTC Bulletin Board: DSCI), a provider of advanced wound care products,
announced today that the most recent study involving MEDIHONEY(TM) Wound &
Burn Dressing shows that use of the dressings are associated with a
reduction in wound size, possibly driven in part by a significant reduction
in overall wound pH. The 20-patient study will be published in the May
edition of the International Wound Journal. The article -- "The impact of
Manuka honey dressings on the surface pH of chronic wounds" -- was written
by Georgina T. Gethin, Seamus Cowman and Ronan Conroy, all of the Royal
College of Surgeons, Dublin, Ireland. The May edition of the International
Wound Journal is a special edition of this globally-recognized
peer-reviewed journal, and will be distributed to the attendees of the
upcoming World Union of Wound Healing Societies conference, to be held in
Toronto this June 4-8.
According to the abstract for the article, the authors evaluated the
progression of 20 non-healing ulcers of various etiologies following
application of the dressings over a period of two weeks. The dressings were
provided by Derma Sciences' global commercialization partner, Comvita New
Zealand, Inc. The authors cite their rationale for researching pH
modulation in chronic wounds as follows:
"Chronic 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 the effect is unknown. Lowering wound pH can
potentially reduce protease activity, increase fibroblast activity and
increase oxygen release, consequently aiding wound healing."
After two weeks of treatment with the dressings, the authors concluded
that, for this group of previously non-healing ulcers, "the use of Manuka
honey dressings was associated with a statistically significant decrease in
wound pH and a reduction in wound size." Significant wound progression
during a two-week period is noted as a strong predictor of good wound
healing outcomes.
Commenting on the article, Derma Sciences CEO Edward Quilty said,
"Method of action is obviously an important component to having a better
understanding of a medical device. Based on the results clinicians have
seen all over the world, and recently here since our launch in the US and
Canada, we have known for quite some time that the dressings work. Now we
are getting a better understanding as to 'why'. Providing the answer to
this question will no doubt increase product usage, as it makes clinicians
feel more comfortable that the product has been studied thoroughly, it is
effective, and we understand why it is effective. Although pH modulation
and the product's high osmolarity have long been thought to contribute to
the effectiveness of the product, it is rewarding to see these beliefs are
being confirmed through good, well structured trials."
He also added, "This is yet another important study focused on
non-healing or recalcitrant wounds that are not progressing with other
advanced wound care modalities. It will only help to improve
MEDIHONEY(TM)'s growing reputation as an effective dressing to 'kick-start'
the healing process. This is what clinicians are reporting to us after
their lengthy clinical evaluations. As we planned, we believe clinicians
are gaining significant confidence in our dressing for very troublesome
wounds. Once this is established in the market, it then becomes only a
matter of time before the dressing is more commonly used even from the
onset of a wound. This will be reflected in growing product sales as we
ramp up throughout 2008 and into 2009."
Press Release: Derma Sciences Receives FDA Clearance to Sell MEDIHONEY(TM) Over the Counter
Products stocked in nationwide pharmacies will provide easy access for consumers
Quote:
Derma Sciences
(OTC Bulletin Board: DSCI), a provider of advanced wound care products,
announced today that its key product line, MEDIHONEY(TM) Wound & Burn
Dressings with Active Leptospermum Honey, has been cleared by the FDA for over
the counter (OTC) sales. This will provide consumers with expanded access to
the products for wounds and burns that do not require the attention of a
medical professional.
CEO Ed Quilty stated, "This is one of the significant milestones we have
been waiting for, and have greatly anticipated since the acquisition of our
new first aid division back at the end of 2007. When we first launched
MEDIHONEY in the US, the media attention it garnered was incredible, pointing
to a large potential market in the consumer arena. This OTC clearance paves
the way for a similar deal to the one we recently announced for MEDIHONEY's
distribution in pharmacies in Canada. We are confident we will be able to
structure an arrangement here in the US with a major pharmacy chain by year
end, and expect to have products available at retail throughout the country by
early 2009. Our goal is to develop and launch novel advanced wound care
technologies into the medical market, and then leverage those technologies --
such as MEDIHONEY and our BIOGUARD(TM) line of antimicrobial gauze dressings
-- to grow our presence in the retail market. Success with this plan will
maximize product access for patients and consumers, and will greatly enhance
value to our shareholders.
"With consumer trends indicating strong interest in naturally derived
health care products, we believe we are hitting the time just right and are
uniquely positioned to offer the only 100% natural FDA cleared product for
wounds and burns that has been tested through rigorous randomized controlled
studies. This will give consumers the ability to have a sterilized,
standardized, and regulated all-natural product in their first aid kits at
home, with the knowledge that the product is safe and effective."
To date, four versions of MEDIHONEY have been cleared by the FDA for sales
into the medical market, and all four were cleared for sales into the OTC
market. According to a 2004 report from marketresearch.com, the United States
first aid market reached $1.5 billion in 2003, and was predicted to reach $2.5
billion by 2008. One quarter of these sales are through private label brands.
Drivers of increasing sales are new technologies, an increasing reliance on
self-care, and the ageing population.
Press Release: Derma Sciences Achieves Significant Commercialization Milestone With Reimbursement Codes for MEDIHONEY(TM)
Quote:
Derma Sciences, Inc, a provider of advanced wound care products, announced today that it has achieved a significant milestone in the launch of its MEDIHONEY(TM) dressing line by securing reimbursement codes for the three recently released new product formulations. The Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC) -- a contracted intermediary and carrier for the Centers for Medicare & Medicaid Services (CMS) -- has notified the company of its decision regarding Healthcare Common Procedure Coding System (HCPCS) codes for billing purposes for the new MEDIHONEY(TM) formulations.
CEO Ed Quilty stated, "This is another significant milestone for Derma Sciences and our launch of the MEDIHONEY dressing line. Navigating through reimbursement hurdles in this industry can prove very challenging, so we are delighted that the new formulations of MEDIHONEY will be reimbursed. This should help to add significant volume to our MEDIHONEY sales, as a large portion of our current sales for this product are to markets driven by reimbursement. As we have announced in the past, the launch of this line has been very successful. The awareness of MEDIHONEY in the wound care market is quite strong after only a few months on the market, and we continue to build an impressive body of clinical evaluations -- at this point exceeding 1,100. The products are being widely adopted, and these new formulations will allow customers to use the products on a much greater variety of wound types."
The new codes will allow applicable customers to bill for all the new MEDIHONEY dressing formulations. Customers will include Medicare's Part B program, private insurance plans, and the various Medicaid programs. Medicare Part B provides coverage for 'Surgical Dressings' for patients at home between clinics or physician visits, and when not receiving home health nursing services. It also provides coverage for wound dressings for residents in Nursing Homes not under a Medicare Part A 'skilled care' benefit stay who have Part B coverage. The Medicaid programs (one for each state) provides coverage for 'Surgical Dressings' for at-home use by the beneficiary. Insurance plans often provide payment for wound dressings in addition to the coverage of care in a Nursing Home and for dressings used at home by the patient and in some cases when home health services are provided. Coverage within these programs greatly enhances Derma Sciences' ability to penetrate the long term care and home health markets, both of which make up a significant share of the overall wound care dressings market. The awarded codes are as follows:
A6237 Hydrocolloid dressing, wound cover, pad size 16 sq. in. or less, with any size adhesive border, each dressing (Item #31422)
A6238 Hydrocolloid dressing, wound cover, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing (Item #31445)
A6234 Hydrocolloid dressing, wound cover, pad size 16 sq. in. or less, without adhesive border, each dressing (Item #31222)
A62334 Hydrocolloid dressing, wound cover, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (Item #31245)
A comparative study between honey and povidone iodine as dressing solution for Wagner type II diabetic foot ulcers.
Shukrimi A, Sulaiman AR, Halim AY, Azril A. Med J Malaysia. 2008 Mar;63(1):44-6.
Quote:
Honey dressing has been used to promote wound healing for years but scanty scientific studies did not provide enough evidences to justify it benefits in the treatment of diabetic foot ulcers. We conducted a prospective study to compare the effect of honey dressing for Wagner's grade-II diabetic foot ulcers with controlled dressing group (povidone iodine followed by normal saline). Surgical debridement and appropriate antibiotics were prescribed in all patients. There were 30 patients age between 31 to 65-years-old (mean of 52.1 years). The mean healing time in the standard dressing group was 15.4 days (range 9-36 days) compared to 14.4 days (range 7-26 days) in the honey group (p < 0.005). In conclusion, ulcer healing was not significantly different in both study groups. Honey dressing is a safe alternative dressing for Wagner grade-II diabetic foot ulcers
I am a community nurse as well as an advance foot care nurse. I have been using Medihoney for a year now. It is one of the best wound care products I have used in years. The Medihoney that we use comes from New Zealand as indicated on the package. I Have had great success in using it on many types of ulcers and burns. If you have the opportunity to use this product I highly recommend you give it a try
A patent has just been granted for this: WOUND DRESSINGS
Quote:
A wound dressing comprises a wound-contacting layer composed of a mixture of honey and a moisture-absorbing agent; a water-permeable fabric backing layer; and an intermediate layer comprising water-permeable fabric impregnated with a mixture of honey and a moisture-absorbing agent.
Medihoney.
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