Abstract
Diabetic ulcers are at risk of becoming chronic and infected, as diabetics have hampered vascular structures, limiting oxygen and nutrient supply. These wounds can lead to pain, malodor, functional problems, and amputation. The current rise in antibiotic resistance demands for complementary therapies. Medical-grade honey (MGH) forms an attractive option because of its antimicrobial and pro-healing properties. We aim to show the beneficial effects of MGH in infected diabetic ulcers. We present six patients with infected diabetic ulcers, of which some were at risk of (further) amputation. Previous treatments with antibiotics, silver and alginate dressings, surgical closure, and maggot therapy were ineffective; therefore, the treatment was switched to the application of MGH. MGH therapy typically reduced the malodor in a couple of days and controlled infection within 2–3 weeks. MGH also enhanced wound healing by promoting granulation tissue formation, angiogenesis, and re-epithelialization, by decreasing inflammatory and oxidative stress and providing nutrients. Together, wound healing was enhanced, and the patient’s quality of life improved. MGH is safe and cost-effective for treating complicated diabetic wounds with (antibiotic-resistant) infections and at risk of amputation. MGH forms a promising alternative or complementary therapy to replace antibiotics for treating locally infected wounds.
Highlights
The prevalence of diabetes mellitus (DM) strongly increased over the last few decades [1]
DM that that is is non-compliant non-compliant to his diabetic diet presented to the wound care clinic with an infected leg ulcer
The treatment was switched to the application of Medical-grade honey (MGH) as monotherapy in all cases except one in which systemic antibiotics had to be administered as part of the hospital regulations
Summary
The prevalence of diabetes mellitus (DM) strongly increased over the last few decades [1]. In 2000, the prevalence was estimated to be 171 million, while this number increased to 451 million in 2017 [1,2]. The latter number already exceeds the predictions from 2004, in which 336 million people were predicted to be affected by 2030 [2]. Recent estimations predict a prevalence of 693 million by 2045 [1]. The comorbidities accompanying DM are serious life-threatening health problems that contribute to higher healthcare costs, reduced quality of life for the patient, and higher mortality rates [3]. A common complication is diabetic foot ulcers (DFU), with one-quarter of all diabetics developing one or more
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