Natürlich heilenWunden

Stellenwert des med. Honigs in der modernen Wundtherapie

heinz mayrhoferdipl. gesundheits- und krankenpfleger, zwm

medical systemssolutions wien

Hippokrates, Aristoteles, Dioskurides/Galen, Avicenna, Paracelsus

Dioscorides, De Materia Medica 78 n. Chr.

Wundversorgung mit Honig

Standardisierungen/ Medihoney

• spezielle Honigmischung aus australisch neuseeländischen Honigen MGO - Methylglyoxal

• standardisierte, antibakterielle, sterile, medizinisch filtrierte Honigmischung

• CE 2b – Wundartikel• keine dokumentierte Allergie

Datenlage• IN VIVO

• 1.• Albietz, J.M. and Lenton, L.M. (2006) Effect of antibacterial honey on the ocular flora in tear deficiency and meibomian gland disease. Cornea. 25. (9): 1012-1019 (*)

• 2.Alcaraz, A. and Kelly, J. (2002) Treatment of an infected venous leg ulcer with honey dressings. British Journal of Nursing. 11. (13): 859-866. (*)

• 3.Acton, C. and Dunwoody, G. (2008) The use of medial grade honey in clinical practice. British Journal of Nursing. 17(20): S38-S44.(**)4.Acton, C. and Dunwoody, G. (2008) Honey: where should it be placed on the wound care formulary? proceedings of European Wound Management Association

Conference, Lisbon, Portugal, May. Poster. (**)5.Acton. C. (2008) Medihoney™: a complete wound bed preparation product. British Journal of Nursing. 17(11) S44-S48 (**)6.Acton, C. (2008) Treatment of a venous leg ulcer found in an intravenous drug user. Wound Essentials. 3: 69-71 (**)7.Bastos, A., Maillard, S., 7 Leschof,P. (2008) Ecology, wound…and antibacterial medial honey. Proceedings of Wounds UK. Harrogate, UK. Poster (*)8.Bateman, S. and Graham, T. (2007) The use of Medihoney™ Antibacterial Wound Gel on surgical wounds post coronary artery bypass grafts (CABG). Wounds UK. 3.

(3): 76-83 (**)9.Blaser, G., Santos, K., Bode, U., Vetter, H. and Simon, A. (2007) Effect of medical honey on wounds colonised or infected with MRSA. Journal of Wound Care. 16. (8):

325-328 (*)10.Bodie Gross, E. (2008) Active Leptospermum Honey impregnated calcium alginate dressing treatment options for medically compromised patients. Proceedings of

World Union of Wound Healing Societies. Toronto, Canada. June. Poster. (***).11.Bradley, T. (2004) “Mummy you smell like honey!”- Utilisation of Medihoney™ Antibacterial Honey in malodorous wound management. Proceedings of Australian and

New Zealand palliative Care Conference. Auckland, New Zealand. Sept. (*)12.Brennan, M.R. and Faliks, S(2008) Wound healing experiences with a honey based product. Proceedings of The World Union of Wound Healing Societies. Toronto,

Canada. June. Poster(***)13.Brennan, M. R., & Faliks, S. (2009). Honey-debriding alternative. Symposium on Advanced Wound Care. Dallas, Texas. April. Poster. (***)14.Brown, B. (2006) Medihoney™ used to address malodour in a chronic venous leg ulcer. Tasmanian Wound Care Association Newsletter. Oct. (**)15.Cadogan, J. (2008) The use of honey to treat a pressure ulcer on the heel of a person with diabetes. The Diabetic Foot Journal. 11(1):43-45. (* / **)16.Chaiken, N. (2009) Active Leptospermum honey for the treatment of recalcitrant lower extremity wounds. Proceedings of American professional Wound Care

Association Conference. Philadelphia, USA, 2-4 April. Poster. (***)17.Chapman, L. (2009) Use of honey on a neuropathic ulcer. Journal of Community Nursing. 23(2): 10-14 (**)18.Cooper, J. (2009) Wound management following orbital exenteration surgery. British Journal of Nursing. 18(6 Suppl): S4-S14 (**)19.Day, J and Zulkowski, K. (2008) use of honey for wound healing a case study. Proceedings of Wound, Ostomy, Continence Nurses Society. Orlando, Florida. June.

Poster.(***) 20.Dunford, C. and Hanano, R. (2004) Acceptability to patients of a honey dressing for non-healing venous leg ulcers. Journal of Wound Care. 13. (5): 193-197. (*)21.Dunford, C. (2001) Treatment of a wound infection in a patient with mantle cell lymphoma. British Journal of Nursing. 10. (16): 1058-1065. (*)22.Dunford, C. (2005) The use of honey-derived dressings to promote effective wound management. Professional Nurse. 20. (8): 35-38. (*)23.Flavin, S., Evans, J. and James, D. (2007) Differentiating between Nicorandil induced ulceration and pressure damage. Proceedings of Wounds UK Conference.

Harrogate, UK. Nov. Poster. (**)24.Fortner, T. T. (2009). The beneficial effects of active Leptospermum honey for chronic, non-healing wounds. Symposium on Advanced Wound Care. Dallas, Texas.

April. Poster. (***)25.Frykberg, R.G., Tallis, A., Thomas-Ramoutar, C. and Hayden, C.T. (2007) Manuka Honey Alginate Wound Dressing facilitates healing of chronic diabetic lower

extremity ulcerations. Proceedings of New Cardiovascular Horizons Conference. New Orleans. September. Poster. (***)26.Gethin G, Cowman S. and Conroy R. (2008) The impact of Manuka honey dressings on the surface pH of chronic wounds. International Wound Journal. 5(2):185-194

(***)27.Grant, T. (2009) Treating pilonidal sinus wounds with an antibacterial wound gel after incision and drainage. Wounds UK. 5(1):78-80 (**)28.

• Hanft, J.R., Smith, T. and Legel K. (2009) Topical active Leptospermum honey in recalcitrant venous leg wounds: A preliminary case series. Proceedings of Diabetic FootGlobal Conference. Los Angeles, USA. 19-21 March. Poster. (***)29.Hayes L. (2008) Leptospermum Honey Alginate Wound Dressing facilitates healing in elderly patients with painful chronic wounds unable to tolerate silver dressings.

Proceedings of World Union of Wound Healing Societies. Toronto, Canada. June. Poster (***)30.Hendrickson, M. A. (2009). Utilizing active Leptospermum honey dressings in the treatment of cutaneous small-vessel vasculitis. Symposium on Advanced Wound

Care. Dallas, Texas. April. Poster. (***)31.Johnson, D.W., van Eps, C., Mudge, D.W., Wiggins, K.J., Armstrong, K.J., Hawley, C.M., Campbell, S.B., Isbel, N.M., Nimmo, G.R. and Gibbs, H. (2005) Randomized,

controlled trial of topical exit-site application of honey (Medihoney™) versus Mupirocin for the prevention of catheter-associated infections in hemodialysis. Journal of American Society of Nephrology. 16. (5): 1456-62. (*)

Datenlage• 32.Johnson D.W., Clark C., Isbel N.M., Hawley C.M., Beller E., Cass A., de Zoysa J., McTaggart S., Playford G., Rosser B., Thompson C., Snelling P. (2009) The

Honeypot Study Protocol: A randomized controlled trial of exit-site application of Medihoney Antibacterial Wound Gel for the prevention of catheter-associated infections in peritoneal dialysis patients. Perit Dial Int. 29. (3):303-309. (**)33.Jull A, Walker N, Parag V, Molan P, Rodgers A. Randomized clinical trial of honey-impregnated dressings for venous leg ulcers. British Journal Of Surgery 2008; 95

(2): 175-82 (***)34.Kavros, S.J. (2008) Utilizing Leptospermum Honey Alginate in the Treatment of Recalcitrant Lower Extremity Ulcerations. Proceedings of American Professional

Wound Care Association Conference. Texas. USA. March. Poster. (***)35.Kesselman, P. (2008) Clinical application of absorbent calcium alginate dressing pads, containing Manuka (Leptospermum) honey on infected lower extremity venous

ulcers. Proceedings of American professional Wound Care Association Conference. Texas, USA, March. Poster. (***)36.Kesselman, P. (2009) Chronic colonized charcot foot ulcer: Clinical application of absorbent calcium alginate dressing pads, containing Manuka (Leptospermum)

honey. Proceedings of American professional Wound Care Association Conference. Phildelphia, USA, 2-4 April. Poster. (***)37.Kroeger, K. (2008) Honig und Wundheilung. The use of medical honey in wound healing. Wund Management. 3: 64-70(*). (German)38.Larsen, T., Reif, S., & Tavernelli, K. (2009). Use of active Leptospermum honey dressings in the home care setting. Symposium on Advanced Wound Care. Dallas,

Texas. April. Poster. (***)39.Liguori, P.A.. and Peters, K.L. (2008) Favorable treatment outcomes of painful chronic leg ulcers with the use of a new active leptospermum Honey impregnated

calcium alginate dressing. Proceedings of World Union of Wound Healing Societies. Toronto, Canada. June. Poster (***)40.Liguori, P.A.. and Peters, K.L. (2008) A new active Leptospermum Honey impregnated calcium alginate dressing has a positive impact on a wide variety of wound

types. Proceedings of World Union of Wound Healing Societies. Toronto.41.Ligouri, P.A. and Peters, K.L. (2008) Limb at risk: use of an active Leptospermum honey for the management of an infected foot wound complicated by cellulitis.

Proceedings of Clinical Symposium of Advanced Wound Care. Las Vegas. USA. Oct. Poster(***)42.Milne, C. (2008) Comparison of honey impregnated alginate dressings to non-impregnated calcium alginate dressings on wound healing. Proceedings of Symposium

on Advanced Wound Care. San Diego, USA.. March. Poster.(***)43.Moore, S. (2008) Squamous cell carcinoma using active Leptospermum Honey for wound management and odor control. Proceedings of South Central region Ostomy

& Continence Society. Oklahoma, USA. September. Poster. (***)44.Oldfield, R. (2007) The utilisation of honey to promote wound bed preparation and healing in a patient with necrotic leg ulcer. Wounds UK Conference. Harrogate, UK.

Nov. Poster.(**)45.Regulski, M. (2008) A novel wound care dressing for chronic venous leg ulcerations. Podiatry Management. Nov/Dec. 235-246 (***)46.Richards, L. (2002) Healing infected recalcitrant ulcers with Antibacterial Honey. Proceedings of 4th Australian Wound Management Association Conference.

Adelaide, Australia. March. Poster. (*)47.47. Robson, V. (2009) Providing evidence on the cost effectiveness of topical Antibacterial Honey dressing for formulary inclusion. Proceedings of. European Wound

Management Association Conference. Finland. 19-21 May. Poster. (**)48.Robson, V. and Cooper, R. (2009) Using Leptospermum Honey to manage wounds impaired by radiotherapy: A case series. Ostomy Wound Management. 55(1):38-

47 (*)49.Robson, V., Dodd, S. and Thomas, S. (2009) Standardized antibacterial honey (Medihoney™) with standard therapy in wound care: randomized clinical trial. Journal

of Advanced Nursing. 65(3): 565-575. (*)50.

• Robson, V., Cooper, R.A. and Ehsan, M.E. (2007) The use of honey in wound management following ENT surgery. Primary Intention. 15. (4): 176-180 (*)51.Robson, V., Martin, L, and Cooper, R. (2005) The use of Leptospermum honey on chronic wounds in breast care. In R. White, R. Cooper and P. Molan (Eds.),

HONEY: a modern wound management product . (pp 103-115). Aberdeen. Wounds UK publishing. (*)52.Robson, V., (2005) The use of Leptospermum honey in chronic wound management. In R. White, R. Cooper and P. Molan (Eds.), HONEY: a modern wound

management product . (pp 79-88). Aberdeen. Wounds UK publishing. (*)53.Robson, V. (2005) The use of Leptospermum honey in slow to heal wounds. Proceedings of. European Wound Management Association Conference. Stuttgart. 15-17

Sept. Poster. (*)54.

• Robson, V. (2002) Leptospermum honey used as a debriding Agent. Nurse 2 Nurse. 2. (11): 66-68. (*)55.Ryan, M. (2008) The use of a medical grade honey (Leptospermum) in salvaging a lower limb in a post operative wound. Proceedings of Wounds UK. Harrogate, UK.

Nov. poster (**)56.Sare, J. (2008) Leg ulcer management with topical medical honey. British Journal of Community Nursing. 13(9): s22-31.(**)57.Schimmer, C., Bensch, M., Sommer, S.P., Hanano, R., Elert, O. and Leyh, R. (2008) Treatment of deep sternal wound infection with V.A.C.® therapy in combination

with local application of antibacterial honey (Medihoney(tm)). Proceedings of 5th joint annual meeting of the German, Austrian and Swiss Societies of Thorax and Cardiovascular Surgery. Innsbruck, Austria, February.(*)58.Schumacher, H.H.A. (2004) Use of medical honey in patients with chronic venous leg ulcers after split-skin grafting. Journal of Wound Care. 13. (10): 451-2.(*) 59.Simon, A., Sofka, K., Wiszniewsky, G., Blaser, G., Bode, U. and Fleischhack, G. (2006) Wound care with antibacterial honey (Medihoney™) in pediatric hematology-

oncology. Supportive Care in Cancer. 14. (1): 91-7.(*)60.Simon, A., Blaser, G. & Santos, K. (2008) Honey in paediatric care and oncology. In Cooper, R., Molan, P. & White, R (eds), HONEY in modern wound management. (pp153-167). Aberdeen, Wounds UK. June.

Datenlage• 61.Simon, A., Traynor, K., Santos, K., Blaser, G., Bode, U. and Molan, P. (2008) Medical Honey for Wound Care - still the "Latest Resort"? eCAM Advance Access.

Evidence-Based Complementary and Alternative Medicine. Available at: http://ecam.oxfordjournals.org/cgi/content/full/nem175v1 (online) (*)62.Smith, T., Legel, K. and Hanft, J.R. (2009) Topical leptospermum Honey (Medihoney) in recalcitrant venous leg wounds: A preliminary case series. Advances in Skin

and Wound Care. 22(2): 68-71.63.Sofka, K., Wiszniewsky, G., Blaser, G., Bode, U. and Simon, A. (2004) Antibakterielle Honig (MedihoneyTM) zur Wundpflege - Wundantisepsis bei pädiatrischen

Patienten in der Hämatologie-Onkologie? [Antibacterial Honey (MedihoneyTM) for Woundcare - an antiseptic option for wound care in paediatric oncology?]. Krankenhaus-Hygiene und Infektionsverhütung. 26. (5):183-187. (*) (German)64.Stead, M. and Oldfield. A. (2007) Use of Honey in a Wound with TB. Proceedings of University Hospitals Coventry and Warwickshire NHS Trust tissue viability

conference. Coventry, UK. December. Poster.(**)65.Stewart, J. (2002) Therapeutic honey used to reduce pain and bleeding associated with dressing change. Proceedings of 4th Australian Wound Management

Association Conference. Adelaide, Australia. March. Poster.(*)66.Strilko, B., Barkauskas,C. McIntosh, A. and Reaney, N. (2008) Use of new active Leptospermum Honey dressings in non-healing wounds. Proceedings of Symposium

of Advanced Wound Care San Diego, USA poster. (***)67.Tavernelli, K. and Reif, S. (2008) The challenges of chronic venous leg ulcers and how leptospermum honey can help. Proceedings of World Union of Wound Healing

Societies. Toronto, Canada. June. Poster.(***)68.Traynor, K. (2007) The healing touch of honey. American Bee Journal. 147(6): 521-52569.Vlahovic, T.C. and Roberts, E. (2008) Active Leptospermum honey: treatment for various lower extremity dermatologic issues. Proceedings of Clinical Symposium of

Advanced Wound Care. Las Vegas, USA. Oct. Poster70.Webb, M. (2008) Management of an MRSA colonized wound using active Leptospermum honey impregnated calcium alginate. Proceedings of 12th Annual Wound

Care Congress. Florida, USA. Sept. Poster.(***)71.Webb, M. (2009) Use of active Leptospermum honey for wound bed preparation and healing in heavily infected multisite wounds at one public long term care facility.

Proceedings of American professional Wound Care Association Conference. Philadelphia, USA, 2-4 April. Poster. (***)72.Webb, M. (2009) Selection of a cost effective debriding alternative to a pharmaceutical enzymatic agent at one county long term care facility. Proceedings of American

professional Wound Care Association Conference. Philadelphia, USA, 2-4 April. Poster. (***)73.Weir, D. And Blakely, M. (2008) The voice of experience: wound management using active Leptospermum Honey impregnated calcium alginate dressing. Proceedings

of World Union of Wound Healing Societies. Toronto, Canada. Poster. (***)74.White, R. and Acton, C. (2006) Honey in modern wound management. MIMS Dermatology. 2. (1): 40-42. (**)IN VITRo

• 75.Blair, S. (2000) Honey and drug resistant pathogens. Proceedings of Joint Scientific Meeting of The Australian Society for Microbiology. Cairns, Australia. July.76.Blair, S.E., Cokcetin, N.N., Harry, E.J., Carter, D.A. (2009) The unusual antibacterial activity of medical-grade Leptospermum honey: antibacterial spectrum, resistance

and transcriptome analysis. Eur J Clin Microbiol Infect Dis 28 (10): 1199-1208 (*)

• 77.Cooper, R.A., Jenkins, R. and Rowlands, R. (2008) The influence of catalase on the antibacterial activity of honey. Proceedings of Symposium on Advanced WoundCare. San Diego, CA. April. Poster.78.Cooper, R.A., Jenkins, L. (2009) A comparison between medical grade honey and table honeys in relation to antimicrobial efficacy;Wounds. 21 (2): 29-36

(**)79.George N., Cutting K. (2007) Antibacterial Honey(Medihoney™): in-vitro Activity Against Clinical Isolates of MRSA, VRE, and Other Multiresistant Gram-negative Organisms Including Pseudomonas aeruginosa; Wounds. 19. (9): 231 – 236 (*)80.George, N. (2004) Honey - Natural Antimicrobial. Proceedings of Australian Infection Control Association Third Biennial Conference. Hobart, Australia

• 81.Igelbrink, D., Koburger, T., Simon, A., Kramer A. (2007) Mikrobiozide Wirksamkeit von Medihoney™ [Microbiocidal efficacy of Medihoney™]. GMS Krankenhaushygiene Interdisziplinär 2 (2)82.Irish, J., Carter, D.A., Shokohi, T. and Blair, S. (2006) Honey has an antifungal effect against Candida species. Medical Mycology. 44. 289-291.83.Irish, J., Carter, D. and Blair, S. (2007) Honey prevents biofilm formation in Staphylococcus aureus. Proceedings of The Australian Society of Microbiology. Adelaide,

Australia. Poster.84.Jenkins, R.E., Cooper, R.A. and Burton, N.F. (2008) A laboratory survey of the antimicrobial properties of honey-containing dressings. EWMA Journal. 8(3): 11-15.

(***)85.Jenkins, R.E., Cooper, R.A. and Burton, N.F. (2008) The determination of antimicrobial activity of 3 honey impregnated wound dressings by challenge test with

EMRSA-15. Proceedings of World Union of Wound Healing Societies. Toronto, Canada, June. Poster. (***)86.Lusby, P.E., Coombes, A.L. and Wilkinson, J.M. (2005) Bactericidal activity of different honeys against pathogenic bacteria. Archives of Medical Research. 36. 454-

467.87.Merckoll P., Jonassen T.O., Vad M.E., Jeansson S.L., Melby K.K. (2009) Bacteria, biofilm and honey: A study of the effects of honey on 'planktonic' and biofilm-

embedded chronic wound bacteria; Scand J Infect Dis. 41 (5): 341 -347 (*)88.Tonks, A.J., Cooper, R.A., Jones, K.P., Blair, S., Parton, J. and Tonks, A. (2003) Honey stimulates inflammatory cytokine production from monocytes. Cytokine. 21.

(5): 242-24789.Wilkinson, J.M. and Cavanagh, M.A. (2005) Antibacterial activity of 13 honeys against Escherichia coli and Pseudomonas aeruginosa. Journal of Medicinal Food. 8.

(1): 100-103.

Breites Einsatzgebiet

• chronische Wunden• akute Wunden• infizierte Wunden• Verbrennungen• eigentlich in jeder Wundphase• Kathetereinstichstellen• Bagatellverletzungen• Diabetischer Fuß

Nutzen mit Medihoney

• Erzeugung feuchten Wundmilieu• Entzündungshemmend• Antibakterielle Wirkung• Geruchsreduktion• Stabiles Narbenergebnis• Wundreinigung• Kombinierbar • kein Einmalprodukt

Nutzen mit Medihoney

• Antibakterielle Wirkung - Inhibinegetestet gegen 250 d. klin. rel. Keime

�Osmose �Glucose Oxidase – Flüssigkeit - Gluconsäure –

H2O2 0,001% (Katalase)

�pflanzliche Verbindungen – Leptospermum�auch Antibiotika resistente Keime

�Methylglyoxal / 300 – 700 mg/kg (Phenolabkömmling)

�Immunmodulierend – T- u. B- Lymphozyten

Antibakterielle Wirkung

Honigprobe

Hofbildung

MRSA-klinisches Isolat

MIC* of 127 Drug-resistant clinical isolates (1990-2004)Narelle George, Qld Health Pathology and Scientific Services,

Royal Brisbane Hospital, Research sponsored by Medihoney Pty Ltd

4%

6%

8%

8%

14%

0% 2% 4% 6% 8% 10% 12% 14% 16%

MRSA / n MRSA

ESBL

VRE

Acinetobacter

Pseudomonasaeruginosa

Concentration of Medihoney (%)

Antibakterielle Wirkung

www.ewma.org

ND= keine Daten verfügbar

++ND+++++++Silber1,22

0NDNDND+++++Maden14-16,19,22

0++++++++ ++++++lod1,22

0+ 0+++++++++Honig22

++0++++++Chlorhexidine 1,22

ResistenzVirenEndosporenPilzegram-neg.gram-pos.

Antimikrobielle Eigenschaften

Anwendungshinweise

Wundversorgung mit Med. Honig

• Wundschutz• Wundreinigung• Wundheilung

Danke für Ihre Aufmerksamkeit!