Nicoara Cezar Doru, Singh Michael, Jester Ingo, Reda Bernadette, Parikh Dakshesh Harivadan
Birmingham Children's Hospital, Birmingham, UK.
Pediatr Surg Int. 2014 May;30(5):515-20. doi: 10.1007/s00383-014-3490-1. Epub 2014 Mar 6.
The aim of this study was to assess the effectiveness of Manuka honey ointment and dressings in the conservative management of exomphalos major (EM).
A retrospective review of five patients with EM who underwent non-operative management with Manuka honey ointments and dressings was carried out to assess the time to complete epithelialisation, time to full feeds, hospital stay, adverse effects, complications and outcome.
The skin epithelialisation over the EM sac was achieved in a median of 63 days (48-119). The median time to full enteral feed was 13 days (3-29). The median hospital stay was 66 days (21-121). No adverse effects were noted related to Manuka honey. Three patients had pulmonary hypoplasia requiring prolonged hospitalization; one of those died with respiratory complications at home after achieving complete epithelialisation. The follow-up was a median 16 months (6-22). Two patients did not require repair of the ventral hernia. One patient had ventral hernia repair at 16 months with excellent cosmesis. The remaining patient is awaiting repair.
This is the first description of the use of medicated Manuka honey ointment and impregnated dressings in the conservative management of EM. This treatment is safe, efficacious and promotes wound healing with favorable outcome.
本研究旨在评估麦卢卡蜂蜜软膏和敷料在巨大脐膨出（EM）保守治疗中的有效性。
对5例接受麦卢卡蜂蜜软膏和敷料非手术治疗的EM患者进行回顾性研究，以评估完成上皮化的时间、完全经口喂养的时间、住院时间、不良反应、并发症及治疗结果。
EM囊上的皮肤上皮化中位时间为63天（48 - 119天）。完全肠内喂养的中位时间为13天（3 - 29天）。中位住院时间为66天（21 - 121天）。未发现与麦卢卡蜂蜜相关的不良反应。3例患者有肺发育不全，需要延长住院时间；其中1例在完全上皮化后在家中因呼吸并发症死亡。随访中位时间为16个月（6 - 22个月）。2例患者无需修复腹疝。1例患者在16个月时进行了腹疝修复，美容效果良好。其余患者正在等待修复。
这是首次描述药用麦卢卡蜂蜜软膏和浸渍敷料在EM保守治疗中的应用。这种治疗方法安全、有效，可促进伤口愈合，效果良好。
