Honing en brandwonden*
Uit een nieuwe studie blijkt dat honing in de behandeling van lichte tot matige
brandwonden evengoed zo niet beter werkt dan een van de traditionele manieren van behandeling met een veel gebruikte crème, het antibioticum zilversulfadiazine (SSD) dat al bijna 50 jaar toegepast wordt om het risico van infecties te verminderen. Over het gebruik van SSD rijzen meer en meer vragen m.b.t. de giftigheid voor huidcellen. Uit een analyse van 26 kleine studies blijkt dat SSD het genezingsproces vertraagt en dat regelmatig het verband gewisseld moet worden. Uit een analyse van 19 studies over honing blijkt dat honing kleine tot matige brandwonden sneller doet genezen dan de traditionele manieren van behandeling.
Wound Treatment - News From The Cochrane Library: Burn Treatment Cream May Delay Healing And Honey Helps To Heal Wounds
Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating burns.
Burn Treatment Cream May Delay Healing
A cream commonly used to treat burns may actually delay healing. In addition, despite the wide range of wound dressings available for burns, there is no consensus on the most effective alternative treatment, say Cochrane Researchers who carried out a systematic review of existing data.
Increased understanding of the wound healing process means that there are now a large number of different ways to treat burns. Films, gels, artificial skins and fibre dressings may all help to heal wounds, but doctors still often turn to traditional gauze dressings, as well as silver sulphadiazine (SSD) cream. Healthcare providers have used SSD cream since the 1960s to minimize the risk of burns becoming infected, although concerns have recently been raised about its toxic effects on skin
cells.
The Cochrane Team who carried out the research found 26 relevant trials. Although each trial was relatively small they concluded that SSD cream increases the time taken for a wound to heal, as well as increasing the number of dressing applications
required.
"We think that the use of SSD cream on burn wounds needs to be reconsidered," says lead researcher, Jason Wasiak, who works for the Victorian Adult Burns Service at the Alfred Hospital in
Melbourne, Australia.
Trials showed that a number of different dressing types, including polyurethane films, hydrocolloid gels and biosynthetic dressings, can be more effective for treatment of moderate burns than SSD or standard chlorhexidine impregnated gauze dressings. As well as reducing healing times, some alternative dressings also reduced pain associated with burns.
Many of the trials, however, failed to adequately assess the depth of burns suffered, so the data was less easy to interpret. The researchers say there is a strong case for larger and better designed trials that will help inform doctors about the most appropriate treatments for burns of different severities.
"There is a need to clearly estimate burn depth in order to make proper recommendations as to the best products for treating burns," says Wasiak.
Wasiak J, Cleland H, Campbell F. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub3.
Honey Helps To Heal Wounds
Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating
burns.
"We're treating these results with caution, but it looks like honey can help speed up healing in some burns," says lead researcher Dr Andrew Jull, of the Clinical Trials Research Unit at the University of Auckland, New Zealand.
Honey has been used in wound treatment since ancient times. The mechanism of action is unclear. While honey may help the body remove dead tissue and provide a favourable environment for the growth of new, healthy tissue, current interest in medicinal honey focuses largely on its antibacterial
effects.
The review brings together data from 19 clinical trials involving 2554 patients with a range of different wounds. Honey was more effective in reducing healing time compared to some gauze and film dressings that are often used to treat moderate burns. However, the researchers were unable to show any clear benefits for the healing of grazes, lacerations, surgical wounds and leg
ulcers.
The researchers don't advise using honey to treat other types of wounds. "Health services should invest in treatments that have been shown to work," says Dr Jull. "But, we will keep monitoring new research to try and establish the effect of honey."
Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005083. DOI: 10.1002/14651858.CD005083.pub2.
(November
2008)
