Wounds International, Vol 1; Issue 1Case studiesThe use of granulated sugar to treat two pressure ulcers

The use of granulated sugar to treat two pressure ulcers

09/11/09 | Pressure ulcers | Moses Murandu, Carol Dealey

 

Week 1 review: On the seventh day, the heel wound bed was granulating (Fig 4). A small amount of slough was present. Maceration of the surrounding skin had resolved. The wound was producing a small amount of non-odorous exudate. The sacral wound had reduced in depth to 2.0cm (Fig 5).

 

 Figure 4

Fig 4: On day 7, the periwound was pink, with less maceration in the wound centre. Granulation tissue could be observed

Figure 5

Fig 5: On day 7 the sacral skin was pink with signs of reduced infection. The sinus had reduced in size to a depth of 2.0cm

 

Week 2 review:  On the 14th day, there was no evidence of infection and less exudate was present in the heel wound (Figs 6 ). Using a Zimmer frame the patient was able to stand and to walk to the toilet and around the bed. The decision was taken to discontinue the sugar dressing and continue with impregnated fabric or tulle gauze dressings (Inadine or Jelonet) only. The use of sugar dressings was continued on the sacral wound for another week (Fig 7).

 

 Figure 6

 Fig 6: On day 14, granulation tissue was visible and central maceration is diminishing. Infection had cleared

 

 Figure 7

 Fig 7: On day 14, the surrounding skin appeared pink and soft, with less evidence of infection present

 

CONCLUSION

This case study reports on the successful use of a white granulated sugar dressing on a patient with two infected pressure ulcers. The heel wound was no longer malodorous within 12 hours of treatment, pain was reduced within two days and the patient was mobile using a Zimmer frame within one week. The sugar dressing facilitated autolytic debridement of the heel wound and promoted granulation tissue formation with a reduction in wound size. A moist wound bed was maintained and bacterial colonisation prevented.

This study demonstrates that sugar, which is a relatively cheap dressing (average cost per dressing change - £1.49/ 1,60 euros / 2.40 USD), can be effective on infected, malodorous wounds of different aetiology, including pressure ulcers.

However, a larger randomised controlled trial comparing white granulated sugar to standard treatment when managing exudating wounds, with parallel economic evaluation, and more laboratory work on the use of sugar dressings, has been planned to prove efficacy and cost effectiveness and to substantiate these earlier conclusions.

 

Author details:

Moses Murandu, MSc, PGcertEd, Cert.IHM, RGN, RM, CertPaeds, SNP, FHA, MIHM, Senior Lecturer, University of Wolverhampton, UK.

Carol Dealey, PhD, MA BSc (Hons), RGN, RCNT, Senior Research Fellow, University Hospital Birmingham NHS Foundation Trust and University of Birmingham, UK

 

References

  1. Engelsen SB, Perez S. Internal motions and hydration of sucrose in diluted water solution. J Mol Graphics  Model 1997; 15(2): 122-31.
  2. Knutson RA, Merbitz LA, Creekmore AA, Snipes LG. Use of sugar and povidone-iodine to enhance wound healing: five years' experience. Southern Med J 1981; 74(11): 1329-35.
  3. Seal DV, Middleton K. Healing of cavity wounds with sugar. Lancet 1991; 338(8766): 571-2.
  4. Mphande AN, Kilowe C, Phalira S, Jones HW, Harrison WJ. Effects of honey and sugar dressings on wound healing. J Wound Care 2007; 16(7): 317-9.
  5. European Pressure Ulcer Advisory Panel. Pressure ulcer treatment guidelines. EPUAP Review 1999; 1(2): 31-3. Available at http://www.epuap.org/gltreatment.html

 

 

Page Points

  • After one week the heel wound was granulating and maceration had resolved
  • After 14 days there were no signs of infection and the heel wound was reduced in size
  • Sugar can be effective on infected, malodorous wounds of different aetiology, including pressure ulcers
  • A randomised controlled trial to compare sugar dressings with standard treatment is needed to substantiate these findings

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