Use of Sugar on the Healing of Diabetic Ulcers: A Review

Biswas, Amit K.; Bharara, Manish; Hurst, Craig A.; Gruessner, Rainer W.G.; Armstrong, David G.; Rilo, Horacio

doi:10.1177/193229681000400512

Cited by 27 publications

(30 citation statements)

References 43 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One particular concept that has gained attention is the use of nonionic hyperosmotic agents such as sugars and honey. [8][9][10] These hyperosmotic treatments have been used extensively to treat acute and chronic wounds with some level of experimental and clinical success. 10,20,21 Previously, we demonstrated that the combination of a membrane disrupting emulsion (i.e., thymol) with hyperosmotic stress synergistically deactivates common and drug-resistant pathogens in vitro.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, hyperosmotic treatments have gained attention in treating chronic and malodorous wounds. [8][9][10] While many of these investigations were case studies or noncontrolled experiments, hyperosmotic saccharides appear to reduce bioburden through a cellular dehydration effect. That is, the low water activity (a w ) of sugars discourages microbial growth.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 The strong hyperosmotic gradients may further improve tissue debridement and microcirculation through osmotic pull of wound fluids. 12,13 Our goal with HNE was to enhance the bacteriostatic properties of the native sugars. Subsequently, HNEs utilize two main components: (1) a high energy lipophilic nanoemulsion composed of thymol and (2) a hyperosmotic saccharide matrix.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Application of Hyperosmotic Nanoemulsions in Wound Healing: Partial Thickness Injury Model in Swine

Connell

Durkes

et al. 2017

Advances in Wound Care

View full text Add to dashboard Cite

In this work, we introduce a novel hyperosmotic nanoemulsion (HNE) topical agent for use in wound healing. These topical emulsion complexes combine a lipophilic thymol nanoemulsion with a hyperosmotic saccharide matrix. This combination has been previously shown to possess synergistic antimicrobial activity against a host of common and drug-resistant pathogens . In this study, we present additional data to assess the safety and efficacy of these emulsions in a partial thickness injury model in swine. Ten wounds sized 2 × 3.5 cm were created in 18 pigs using an electrodermatome set at a depth of 0.76 mm. The wounds were subsequently contaminated with a cocktail of ,, , and at 5 × 10 total colony forming unit per wound. Treatments were subdivided in the control group and emulsion concentrations at 0.0%, 0.01%, 0.03%, and 0.063% thymol content. Longitudinal metrics for wound healing included rate of reepithelialization, wound bed color measurements, amount of wound exudate, wound swab culture data, and histological examination at 4, 7, and 14 days. The cosmetics of the healed wound were obtained at day 14 with three-dimensional photogrammetry. Experimental results showed that HNE reduced the wound level bacteria count by ∼0.5-1 log versus controls after 24 h. The amount of pathogen reduction was weakly correlated to the concentration of the emulsion. In addition, all HNE groups maintained a moist wound environment and showed increased fibrin formation and improved hemostatic response. No significant difference in the rate of reepithelialization or wound closure was found between treatment concentrations and control groups. HNE treatment did not demonstrate any adverse host tissue response. These results suggest HNE may be a candidate for reducing wound bacterial counts without compromising reepithelialization.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Application of Hyperosmotic Nanoemulsions in Wound Healing: Partial Thickness Injury Model in Swine

Connell

Durkes

et al. 2017

Advances in Wound Care

View full text Add to dashboard Cite

show abstract

“…[83][84][85] However, sugar is rapidly diluted following application and frequent reapplication may be needed to prevent bacterial adaptation. 86 In order to hold diluted sugars in place, petroleum jelly with glycerin may be…”

Section: Sugarmentioning

confidence: 99%

“…Other authors have applied sugar to infected wounds and reported amelioration of fetid odors within 3 to 4 days. [83][84][85] Honey has also gained more widespread clinical use in the past decade for management of chronic wounds. [116][117][118][119][120] In a 4-center feasibility study, Dunford and Hanano 121 evaluated a honey-based product and found that it reduced wound odor in patients with leg ulcers.…”

Section: Efficacy Of Various Treatments On Wound Odormentioning

confidence: 99%