treatment of wounds

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© Th. Cherbuliez, M.D.© Th. Cherbuliez, M.D.

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Treatment of WoundsTreatment of Wounds

Description

CMACCCMACC

2009 December 05

Th. Cherbuliez, MD

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Steps in healing

WoundWoundDescriptionDescription

The lesion can be acute or chronicThe lesion can be acute or chronic

A lesion of the skin or/and mucosaA lesion of the skin or/and mucosa

They can come from a burn, a cut, a compression, a They can come from a burn, a cut, a compression, a fracturefracture

They can be clean or infected.They can be clean or infected.

They can be superficial or include deep tissue They can be superficial or include deep tissue lesionlesion

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Role of honey

WoundWoundSteps in healingSteps in healing

1) Protect the place from further mechanical and 1) Protect the place from further mechanical and infectious attackinfectious attack

Rest is, in general, the most propitious state for Rest is, in general, the most propitious state for healing; therefore:healing; therefore:

2) Clean the area of dead and decaying cells, 2) Clean the area of dead and decaying cells, coagulated materialscoagulated materials

3) Disinfect and nourish the new tissues3) Disinfect and nourish the new tissues

These steps “treat” the wound and the rested wound heals These steps “treat” the wound and the rested wound heals itself.itself.

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Roles of bee products

WoundWoundto “treat” the woundto “treat” the wound

Role of HoneyRole of Honey

Covers the wound, no further bacterial or Covers the wound, no further bacterial or mechanical insultmechanical insultSaturation of the sugar content dehydrates Saturation of the sugar content dehydrates bacteriabacteriaGenerating OGenerating O+ + “burns” bacteria and dead tissues “burns” bacteria and dead tissues

Protects wound from losses: fluids, Protects wound from losses: fluids, electrolytes.electrolytes.

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Wound cover; Scientific qualities

Roles of bee Roles of bee productsproducts

to “treat” the woundto “treat” the woundRole of PropolisRole of Propolis

Role of bee venomRole of bee venom

Role of PollenRole of Pollen

DisinfectantDisinfectant

AnestheticAnesthetic

Increases blood circulation in and around the Increases blood circulation in and around the wound tissuewound tissue

Brings proteins and electrolytes to the wound.Brings proteins and electrolytes to the wound.

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Practical qualities

Scientific qualities of Scientific qualities of wound coverwound cover

by by N. Marsit N. Marsit (Apimondia 09) (Apimondia 09)

Not antigenicNot antigenic

Non inflammatoryNon inflammatory

Protects wound from external bacteriaProtects wound from external bacteria

Protects wound from evaporation and Protects wound from evaporation and electrolyte losseselectrolyte losses

Fosters granulation and epithelializationFosters granulation and epithelialization

Accelerates wound healing.Accelerates wound healing.

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Wound cover

Practical qualities of Practical qualities of wound coverwound cover

PricePrice

AvailabilityAvailability

Adhere to the wound without sticking or destroying Adhere to the wound without sticking or destroying new cells when removednew cells when removed

Easy conservationEasy conservation

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Burn wounds

Wound coverWound cover

HHoney impregnated amnion grafts could keep four oney impregnated amnion grafts could keep four years at room temperature. years at room temperature.

Human amniotic membranes sterilized by gamma Human amniotic membranes sterilized by gamma rays from cobalt-60 sources rays from cobalt-60 sources

To increase conservation time of the prepared To increase conservation time of the prepared amnion grafts:amnion grafts:

Creation of a skin substitute as biological Creation of a skin substitute as biological dressingdressing

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Abdominal surgical wounds

Wound treatmentWound treatmentBurns by A Berretta-Silva Burns by A Berretta-Silva

(Apimondia 09)(Apimondia 09)

This is a product that maintains its liquid state This is a product that maintains its liquid state in low temperatures and provides in situ gelling in low temperatures and provides in situ gelling property. property.

A thermo-reversible polymer that provides A thermo-reversible polymer that provides sustained delivery of a formulation containing sustained delivery of a formulation containing standardized propolis extract standardized propolis extract

It enhances patient’s comfort and acceptance, and It enhances patient’s comfort and acceptance, and obtains a histological well-organized skin tissue obtains a histological well-organized skin tissue that reduces wound healing time. that reduces wound healing time.

Protected by patentProtected by patent

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Chronic bone wound

Surgical, infected Surgical, infected woundswounds

Bernard DescottesBernard Descottes✝✝(Apimondia 09) (Apimondia 09)

Head of Division of visceral surgery in University Head of Division of visceral surgery in University Hospital in Limoges, France and Number 2 in France for Hospital in Limoges, France and Number 2 in France for liver transplantliver transplant

In the last 24 years honey is the only product used In the last 24 years honey is the only product used in this division for the healing of all wounds. in this division for the healing of all wounds.

87 % of the >3500 wounds treated heal without 87 % of the >3500 wounds treated heal without complications. Results are faster and cheaper than those complications. Results are faster and cheaper than those of commercial preparations.of commercial preparations.

Since 1984 study of Honey for the healing of major Since 1984 study of Honey for the healing of major abdominal post-operative, clean or infected woundsabdominal post-operative, clean or infected wounds

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Antibiotics vs Apittt

Chronic, deep Chronic, deep woundwound

By the Apitherapy Commission of By the Apitherapy Commission of ApimondiaApimondia

Lavage with honey-propolis-essential oils for 9 Lavage with honey-propolis-essential oils for 9 months until cleanmonths until clean

Man, distal end of femur infected for 42 years. Wound Man, distal end of femur infected for 42 years. Wound drains pus, resistant to all used antibiotics. drains pus, resistant to all used antibiotics. Patient candidate for amputationPatient candidate for amputation

Surgical curettage of the wound. Cavity left Surgical curettage of the wound. Cavity left emptyempty

Further care of the wound with honey mix until closed 4 Further care of the wound with honey mix until closed 4 months latermonths later

Patient’s knee ankylosed. He can walk without cane.Patient’s knee ankylosed. He can walk without cane.

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Examples of wounds

Antibiotics vs Antibiotics vs ApitherapyApitherapy

Date Antibiotics Days Cost USD Cost/months

2000 September Amikacine 10,7,10,3,3

Amixiciline 8

Amoxicicline

6,7

Cefalexine 8 Ceporane 9

Chloramphenicol 9,6

Ciprofloxacile 7,4,8,10,9,8

Cloxacicline 9 Erytromycine 6,10,7,7,7 Kanamicine 4 Metronidazol 6 Oxaciline 2 Penicilline 9 Rifampicine 7 Sulfaprine 7,5,8,5 Tetracicline 9,6,6

2001 December Vancomicine 9

Antibiotics 15 months 269 7,303.92 486.93

Apitherapy 9 months 270 600.00 66.67 (≈14%)

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Fish bone wound

WoundWoundExamplesExamples

Chronic ankle ulcerChronic ankle ulcer

Infected wound by fish boneInfected wound by fish bone

Bed soreBed sore

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.S.M. 43 (F) Infected wound by fish bone S.M. 43 (F) Infected wound by fish bone (Staphilococcus aureus) . The seventh day (Staphilococcus aureus) . The seventh day

after.after.

After 7 days antib.After 7 days antib.

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This is the situation after This is the situation after 7 days of antibiotic 7 days of antibiotic

therapytherapy

Healing after 10 days Healing after 10 days of maggot therapy and of maggot therapy and 25 days of honey 25 days of honey dressing.dressing.

One year laterOne year later

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.This is the situation one This is the situation one year later.year later.

Chronic Ulcer w. HoneyChronic Ulcer w. Honey

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.HoneyHoneyChronic ulcerChronic ulcer

Bed sore w. BVTBed sore w. BVT

After 60 days of Honey After 60 days of Honey treatment.treatment.

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Chronic ulcer.Chronic ulcer. One month One month later.later.

Two months Two months later.later.

Three month Three month later.later.

Treated with bee Treated with bee venomvenom..

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Thank youThank you

treatment of wounds

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