Die Behandlung chronischer Wunden im Kopf-Hals-Bereich nach Radiatio mit medizinischem Honig

 

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Zusammenfassung

Hintergrund: Wundheilungsstörungen und chronische Wunden können ein Problem nach Radiatio darstellen. Sie treten spontan oder nach weiteren chirurgischen Maßnahmen auf. Durch die radiogen veränderte Gewebebeschaffenheit werden rezidivierende bakterielle Infektionen mit nässenden Wunden gefördert, die häufig mit konventionellen konservativen Wundbehandlungsmaßnahmen nur unzulänglich behandelt werden können. Die topische Applikation von medizinischem Honig scheint in solchen Fällen einen positiven Effekt auf die Wundheilung zu haben. Ziel unserer klinischen Anwendungsstudie ist die Überprüfung dieser Wirksamkeit in der Behandlung von Wundheilungsstörungen bzw. chronischen Wunden im Kopf-Hals-Bereich bei bestrahlten Patienten.

Patienten und Methode: Im Zeitraum von Juli 2012 bis August 2013 wurden in unserer Klinik neun Patienten mit medizinischem Honig behandelt. Bei allen Patienten lag ein Z. n. Radiatio im Kopf-Hals-Bereich vor. Fünf Patienten litten nach Salvage-Chirurgie an protrahierten Wundheilungsstörungen. Bei 4 Patienten lagen spontan aufgetretene Wunddehiszenzen zu Behandlungsbeginn vor. Es wurde der Wundheilungsverlauf durch Ausmessung der Wundränder und -tiefe samt begleitender Fotodokumentation belegt.

Ergebnisse: Bei allen Patienten verlief die klassische konventionelle Wundheilung frustran. In 8 von 9 Fällen konnten unter Anwendung des medizinischen Honigs die Wunden über einen Zeitraum von 3–8 Wochen erfolgreich zur Abheilung gebracht werden. Es traten in keinem Fall Nebenwirkungen bzw. allergische Reaktionen auf den Honig auf.

Schlussfolgerung: Aufgrund unserer klinischen Erfahrung halten wir die topische Anwendung von medizinischem Honig bei Wundheilungsstörungen oder chronischen Wunden nach Radiatio im Kopf-Hals-Bereich für eine sinnvolle und erfolgreiche Therapiealternative.

Abstract

Background: Wound healing problems and chronic wounds can be a therapeutic challenge are a frequent problem after radiotherapy. They can appear spontaneously or after further surgery. The permanently altered tissue is associated with recurrent bacterial infections with weeping wounds, which cannot be treated sufficiently by conventional conservative wound care. The topical application of medical honey seems to have a positive effect in such cases. The aim of this prospectively study is to check this effectiveness in the treatment of wound healing problems and chronic wounds in the head and neck area of irradiated patients.

Patients and methods: In the period of July 2012 until August 2013 nine patients were treated with medical honey. All pa­tients had previously radiotherapy in the head and neck area. 5 patients had protracted wound healing problems after salvage surgery. The remaining 4 cases had spontaneously dehiscenced wounds at the beginning of the study. The wound healing was confirmed by measurement of the wound edges and depth and by adequate photo documentation.

Results: In all cases, the conventional wound care was unsuccessfully. In 8 of 9 cases, the wounds could be brought to cure by the application of medical honey over 3–8 weeks. Side effects or allergic reactions to the medical honey were not seen in any ­cases.

Conclusion: Based on our clinical experience we believe that the topical application of medical honey in non-healing or recurrent wounds in the head and neck area after radiotherapy is a reason­able and successful alternative therapy.

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