Abstract
The present prospective study was aimed to evaluate the effectiveness of topical application of bee honey on wound healing with hyper granulation tissue of infected split skin graft. Methods: A 27 years old female was admitted to Khartoum North Teaching Hospital plastic surgery unit with painful swelling of the right buttock with localized heat, which was proved as a pyogenic abscess. Swabs were taken from the wound for isolation, identification and viable bacterial count. The abscess was drained under general anesthesia and dressed with saline and MEBO ointment (combination of honey and herbs). Skin graft was performed. After 2 weeks of MEBO dressing, the wound was infected and hyper granulation tissue was observed. Daily application of honey was used instead of MEBO ointment. Results: Isolated organism was identified as Staphylococcus aureus. In vitro antibacterial test of honey against the isolated organism exhibited strong antibacterial activity. After one week of honey dressing, bacterial growth was inhibited and finally the wound was free from S. aureus. After 2 weeks of honey dressing, wound healing with reduced, hyper- granulation tissue was found. Conclusion: Topical application of honey dressing on wound with hyper granulation tissue for 3 weeks resulted in clean sterile wound with healthy granulation tissue and prompt graft was observed. Complete wound healing was achieved and hyper granulation tissue was reduced without surgical interference.
Highlights
The formation of persistent granulation tissue, known as hyper granulation tissue, or hypertrophic granulation, is a complication of surgical wound healing
The isolated organism was identified as Staphylococcus aureus according to the conventional microbiological tests
Our result showed that honey improved hypergranulation tissue formation to the wound level without surgical interference
Summary
The formation of persistent granulation tissue, known as hyper granulation tissue, or hypertrophic granulation, is a complication of surgical wound healing. Hyper granulation tissue fills beyond the height of the wound and prevents keratinocyte migration from wound edges to complete epithelialization[1]. It presents as exophytic, erythematous, and friable tissue[2]. Treatment of the tissue can be managed by chemical cautery with silver nitrate or topic corticosteroids to help epithelialization and migration of keratinocytes from the wound edges leading to wound healing process[4, 5]. Wound healing can be affected by changes in pH at every phase[7, 8]. Wound healing process includes hemostasis, different inflammation process, proliferation, and remodeling[2, 11] One of the effective healing factors is the pH, different pH ranges are required for the different phases of wound healing[12]
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