Klinik und Poliklinik für Herz– und Thoraxchirurgie Direktor: Prof. Dr. R. Leyh

Treatment of deep sternal wound infection with V.A.C.® therapy in combination with local application of antibacterial honey (Medihoney™)

Schimmer C 1, Bensch M 1, Sommer SP 1, Hanano R 2, Elert O 1, Leyh R 1

Objectives: It is well known that antibacterial honey (Medihoney™) has been effective in the treatment of

various types of wounds, but there is not any information in the literature about the usage of local application of Medihoney™ in combination with V.A.C.® therapy in the treatment of deep sternal

wound infections (DSWI).

Methods: We report about our experience with a series of 8 patients treated for DSWI with the V.A.C.®

therapy in combination with local application of Medihoney™.

Conclusion: This was an observentional study with no control group. However, we conclude that antibacterial honey

(Medihoney™) in combination with the V.A.C.® therapy is useful in the treatment of DSWI. Based on our first experience, we will conduct a prospective randomized trial to assess the influence of Medihoney™ in the

treatment of DSWI.

Results: There were no local or systemic adverse reactions to the treatment, specifically no hyperglycaemia. All patients showed marked clinical

improvement. After V.A.C.® therapy and secondary thoracic closure by plastic reconstruction 6/8 patients went on to complete wound healing.

The wounds were clean and sterile in these 6 patients after a mean duration of treatment of 23 days (range 9 - 29 days) and a number of applications of 6 times (range 5 - 8 times). Repeated positive wound

cultures, definded as wound cultures positive longer than 30 days were positive in 2 patients. However, these two patients achieved only

intermittent application of Medihoney™. No nosocomially acquired superinfections (particularly Methicillin-resistent Staphylococcus aureus and Vancomycin-resistent Enterococci) were observed.

Pat. Wound culture

steril at day

Number ofapplication

VAC - changes

MRSA -superinfection

Comment

1 9 5 6 no Complete wound healing

2 26 7 9 no Complete wound healing

3 not sterile 8 11 no Repeated positive wound cultures

4 28 6 10 no Complete wound healing

5 25 5 7 no Complete wound healing

6 29 6 8 no Complete wound healing

7 19 5 7 no Complete wound healing

8 not sterile 8 12 no Repeated positive wound cultures

Tab. 1: Overview of all patients treated with Medihoney™

1 Universität Würzburg, Klinik und Poliklinik für Thorax-, Herz- und Thorakale Gefäßchirurgie2 Ralno Biomedical Consulting and Services, 89308 Günzburg