Saturday, December 01, 2007

Alternative Treatments for Wounds: Leeches, Maggots, and Bees

By Ramaz Mitaishvili, Abkhazia Institute for Social and Economic Research, 11/30/2007

The recalcitrant nature and complexity of chronic wounds continue to challenge health practitioners in the field, with many of the standard treatment options often failing to provide good outcomes. Chronic wounds are often infected with bacteria resistant to antibiotics, compounding the problem. Some alternative biologic forms of treatment have been used and are gaining recognition; they include apitherapy (application of honey), maggots, and leeches. In addition to other wound-promoting actions, they all seem to show efficacy against bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA).

Honey -- A Topical Treatment for Wounds In recent years, there has been a resurgent interest in the use of honey in wound care. Honey, a plant nectar that is modified by the honey bee Apis mellifera, has been used as a treatment for wounds since antiquity, with records of its use dating back to the early Egyptians, Assyrians, Chinese, Greeks, and Romans.

There are several mechanisms through which honey is thought to act on and heal wounds. When it is applied directly on a wound surface or via a dressing, it can act as a sealant, keeping the wound moist and free from contamination. In addition, honey is comprised of glucose (35%), fructose (40%), sucrose (5%), and water (20%). This high sugar content plus vitamins, minerals, and amino acids) provides topical nutrition that is thought to promote healing and tissue growth. Honey is also a hyperosmotic agent that draws fluid from the wound bed and underlying circulation, which kills bacteria that cannot thrive in such an environment. It is bactericidal in other ways as well. During the process of honey production, worker bees add the enzyme glucose oxidase to the nectar. When honey is applied to the wound, this enzyme comes into contact with oxygen in the air, which leads to the production of the bactericide hydrogen peroxide. Macroscopically, honey has also shown debriding action…

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