The use of Advancis Manuka honey dressings used on pressure sores in the Centre for the Rehabilitation of the Paralysed in Bangladesh

Jan Varney - Retired Practice Educator, Treliske hospital & District Nurse Team Leader

The Centre for the Rehabilitation of the Paralysed in Bangladesh is the only spinal injury hospital in the country. The prevalence of pressure sores is of concern and this is due to patients being admitted to CRP with pressure sores either coming from home or other hospitals. There needs to be a national awareness campaign regarding the prevention of pressures sores with patients sustaining a spinal injury. Often the patients are left in their village after having sustained a spinal injury with no knowledge of the importance of regular change of position and no treatment for their incontinence. Sometimes they are admitted to a hospital where there is also no awareness of how to treat a patient with a spinal injury.

CRP has in the past put courses on for nurses and health care professionals regarding the care of the patient with a spinal injury and there is an obvious need for further courses.

I spent 3 weeks working as a volunteer at CRP in February 2012 and was upset to see so many patients with grade 4 pressure sores which could have been avoided with the correct knowledge regarding prevention. I took some Advancis Manuka honey dressings with me; however I only had a limited supply so I was very selective with the use of these dressings. I would like to share the results of using these dressings on 3 patients with grade 4 pressure sores.

Patient 1

Patient 1 was 24 years old and a farmer; he sustained a spinal injury (dorsal 9) from falling from a tree. He was admitted to a hospital in Dhaka for 13 days and then discharged home. His family noticed that he had discharge coming from his sacral area. He was admitted to CRP with a grade 4 pressure sore which was infected and necrotic in appearance. At CRP he had his position changed 2 hourly, a high protein diet, bloods were taken for cultures and haemoglobin levels.

Day 1

Day 10

Day 16

Patient 2

Patient 2 was 26 years old and a rickshaw–puller, he had a road traffic accident and sustained injury (lumbar 2). He was admitted to a hospital in Dhaka for 13 days and then discharged back to his home in Dhaka. His family noticed that there was a big sore on his back; this was a grade 4 pressure sore so he was admitted to CRP. 

Day 1

Day 10

Day 16

Patient 3

Patient 3 was 30 years old and worked as a labourer. He was walking with a heavy load on his head and he slipped. He sustained a spinal injury (cervical 7). He was admitted to a hospital in Dhaka for 7 days where he was left in one position. He was discharged back home but was then readmitted to hospital as his family noticed that he had a sacral pressure sore. After a month his condition hadn’t improved so he was admitted to CRP.

Conclusion

Out of the honey dressings that I used I found that Activon Tulle was more successful in conforming to the shape of the wounds; the honey was excellent to deslough and keep the wound hydrated.