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蜂蜜敷料:骨科伤口护理的一种被忽视的方法。

Honey dressing: a missed way for orthopaedic wound care.

机构信息

Department of Orthopaedic Surgery, Benha Faculty of Medicine, Benha University, Farid Nada Street, Kalyubia, Benha, Post Office 13518, Egypt.

出版信息

Int Orthop. 2022 Nov;46(11):2483-2491. doi: 10.1007/s00264-022-05540-9. Epub 2022 Aug 16.

Abstract

PURPOSE

Orthopaedic-related wounds are critical situations calling for care to avoid deep infections and its consequences. The purpose of this study was to evaluate the efficacy of using honey for care of orthopaedic-related wounds with limited resources.

PATIENTS AND METHODS

This prospective study included 50 cases with an average age of 38.18 (range 17-63) years with 38 males and 12 females. The most frequent wound location was the leg (41 patients; 82%), then the foot (six patients; 12%), and the ankle in three patients (6%). The aetiologies were open fractures (34 cases; 68%), infected tibial non-unions (nine cases; 18%), and post-operative infections (seven cases; 14%). Exposed tendon was present in three cases. Bone exposure was present in two cases. Deep infection was present in 29 cases (58%). Besides treating the primary cause, a ribbon of gauze soaked with honey was applied to the wounds after thorough saline washing.

RESULTS

Wound sizes were variable. All cases showed improvement in all parameters with complete wound healing and full coverage of bone and tendons. Recurrence of deep infection occurred in three cases and treated by debridement. One case needed sequestrectomy of a small exposed tibial cortical fragment. Exposed tendon cases showed superficial necrosis which was treated by simple debridement. Initial mild itching occurred in five patients with spontaneous resolution.

CONCLUSION

With treating the underlying aetiology and optimising the patient's general condition, honey was an effective, simple, and affordable method of wound care in different orthopaedic conditions even with exposed bone or tendons.

摘要

目的

骨科相关伤口属于危急情况,需要妥善处理,以避免深部感染及其后果。本研究旨在评估在资源有限的情况下使用蜂蜜护理骨科相关伤口的疗效。

患者和方法

这是一项前瞻性研究,纳入了 50 例患者,平均年龄为 38.18 岁(17-63 岁),其中男性 38 例,女性 12 例。最常见的伤口部位是腿部(41 例;82%),其次是足部(6 例;12%)和踝关节(3 例;6%)。病因包括开放性骨折(34 例;68%)、感染性胫骨骨不连(9 例;18%)和术后感染(7 例;14%)。3 例存在肌腱外露,2 例存在骨外露,29 例(58%)存在深部感染。除了治疗原发病外,我们在彻底用生理盐水冲洗后,将浸有蜂蜜的纱布条应用于伤口。

结果

伤口大小不一。所有病例的所有参数均有改善,伤口愈合良好,骨和肌腱完全覆盖。3 例发生深部感染复发,经清创治疗;1 例需要小的胫骨皮质碎片骨切除术;2 例肌腱外露病例出现表浅坏死,经简单清创治疗。5 例患者最初出现轻度瘙痒,自行缓解。

结论

在治疗基础病因和优化患者一般状况的基础上,即使存在骨或肌腱外露,蜂蜜也是一种有效、简单且经济实惠的骨科不同情况下的伤口护理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f63/9556393/21e812dd0c9c/264_2022_5540_Fig1_HTML.jpg

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