When Cody started licking at a small lesion on his paw, the
owner’s grandchildren knew that licking a wound delays healing, so they covered
the area with a plastic bag. The puzzled
owner of the Sheltie was now in our exam room, concerned because she had just
noticed some sticky matted fur just above Cody’s ankle. After thoroughly clipping and cleaning the
wound, I found that it was at least ½-inch deep and extended around almost the
entire circumference of Cody’s leg. It
was typical of a wound caused by a rubber band, and indeed the owner realized
that her grandchildren had used a hair elastic to secure the plastic bag.
Because the linear cut was so deep and contained dead tissue
and pus, I chose to use a wound management technique that has been around since
the 1600s: sugar.
There’s science behind the use of granulated sugar for this
purpose, and it’s based on water. Sugar
absorbs moisture, and bacteria don’t like that; they require water to
thrive. So sugar in a wound inhibits
bacterial growth. Sugar also decreases
tissue inflammation, attracts disease-fighting white blood cells, helps slough
devitalized tissue while nourishing the healthy tissue, and forms a protective layer of protein on the
wound that promotes healing. None of the antibacterial ointments we use on
wounds can claim all those benefits, nor are they as inexpensive as sugar.
After the lesion is thoroughly cleaned, copious amounts of
sugar are poured on the wound, which is then wrapped with a sterile absorbent
dressing. As the sugar draws moisture
from the tissue, it eventually becomes diluted and less effective. A bandage change must be done whenever strike-through
has occurred, which is when moisture seeps to the outer layer of the dressing. That might necessitate changing the bandage at
least twice a day.
Because of that, and because sugar bandages are messy to
apply, many veterinarians prefer another sweet treatment: honey.
Unpasteurized honey has been a staple in wound cleansing and
healing in humans for 4,000 years. The
active enzymes in honey contribute to its effectiveness but are destroyed by
heating, so raw honey does best. In
addition to working like sugar, honey contains an antibacterial factor called
inhibine, which is actually hydrogen peroxide (H2O2). You might have heard that hydrogen peroxide
can damage healthy tissue cells; that’s true, but the level of H2O2 produced by
honey in one hour is 1,000 times less concentrated than the 3% stuff you have
in your medicine cabinet. That tiny
amount of peroxide is antibacterial and is continuously generated by the
honey. It also stimulates the growth of
blood vessels and healing tissue. Best
of all, there is no reported microbial resistance to honey; even multi-drug-resistant
bugs succumb.
One way to apply honey is to soak an absorbent dressing with
it after cleaning the wound. Medical-grade
honey, which is free of contaminants such as pesticides, is best. Commercial honey dressings also are available. Honey dressings wick away moisture and adhere
to the wound, which makes them excellent for debriding dead tissue from that
area. The bandages are changed once or
twice a day, depending on how much strike-through occurs.
Both honey and sugar bandages are used for a couple of days
to a couple of weeks. The end point is
when a healthy pink bed of new tissue has formed.
My client’s Sheltie did really well with his sugar dressing: By the next day, the wound was clean and the
tissue a nice rosy color.
Antibiotics are an important part of our armamentarium when
we fight infection. But it’s pretty cool
that I could use something simple on Cody’s wound that was even better than
antibiotics and – more important – didn’t contribute to the creation of the
antibiotic resistance that is ubiquitous today.
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