The use of granulated sugar to treat two pressure ulcers
09/11/09 | Pressure ulcers | Moses Murandu, Carol Dealey
This innovative case report presents the management of a patient with two infected pressure ulcers, one on the heel and one on the sacrum, using a granulated sugar dressing.
Granulated sugar is the disaccharide sucrose and will combine with other substances such as water . When sugar is applied to a wound it will normally dissolve within four hours, creating a highly concentrated environment on the wound surface. Body fluids are attracted to the wound surface to equalise the high concentration gradient (osmosis), increasing the volume of exudate produced. This appears to cleanse/irrigate the wound and to liquefy devitalised dead tissue. The dead tissue is removed each time the wound is re-dressed, promoting the generation of new tissue.
Sugar is widely used in a number of countries across Africa and there has been more limited use in the UK and the US. To date, there is scant evidence of its efficacy in infected wounds; the largest study in the US ran over a 56-month period and treated a total of 605 patients with wounds of different aetiologies. The study reported rapid wound healing when using sugar and povidone-iodine to enhance wound healing .
In the UK, one small case study found that packing malodorous pressure ulcers with sugar paste stopped the odour and debrided necrotic tissue . More recently, Mphande et al (2007) compared the effects of sugar and honey on wound healing and observed no significant difference between the two .
The patient in the following case study is one of 21 patients who participated in a small pilot study in a UK hospital exploring the effectiveness of dry granulated sugar on exudating wounds. This study aimed to develop a protocol for use with a randomised controlled trial to compare dry granulated sugar with standard treatment.
This report presents a 72-year-old man who had undergone surgery to remove a brain tumour 10 years previously. He had experienced weakness in his left leg, which had led to increased mobility problems. The patient was cared for at home by his family, with the help of community nurses. However, when his mobility reduced further, he spent more time in bed and he developed a pressure ulcer on his heel. After eight weeks in one hospital in the West Midlands in the UK, the ulcer had deteriorated and he was transferred to an acute specialist hospital where the pilot study was taking place. He had also developed a secondary sacral pressure ulcer.
At the acute hospital, both wounds were dressed with an alginate dressing with activated carbon (Sorbsan Plus, Aspen Medical) for two weeks. However, both wounds failed to improve and continued to deteriorate. At this point, it was proposed that the patient would be a good candidate for participation in the pilot study. After a full explanation and discussion with both the patient and his family, informed consent was obtained.
- The use of granulated sugar dressings on a wound increases the amount of exudate produced, which appears to cleanse/irrigate the wound and liquefy necrotic tissue, facilitating autolytic debridement
- A 72-year-old man with a painful, infected, malodorous heel pressure ulcer with areas of maceration was treated with a granulated sugar dressing