Effects of honey compared to silver sulfadiazine for the treatment of burns

“Topical dressings containing honey as well as silver sulfadiazine (SSD) have re-emerged as a treatment option for burn wound management. Honey is postulated to facilitate wound healing by its chemical debridement and anti-inflammatory action, and its ability to create a viscous barrier on the wound surface thus preventing the invasion of micro-organisms. Meanwhile, SSD may be considered as the gold standard for topical burn treatment. In contrast to honey, silver-containing dressings are capable of absorbing the burn exudates and releasing silver which has been recognized as an effective antimicrobial agent against a broad range of bacteria, yeast, and viruses. However, recent findings have shown that topical silver delays rather than promotes wound healing and is associated with potentially severe adverse effects.”

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Early diagnosis and risk factors of necrotizing soft tissue infection

Fernando SM, Tran A, Cheng W, et al. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019 Jan;269(1):58-65. doi: 10.1097/SLA.0000000000002774. Full-text for Emory users.

Conclusion: “Our systematic review found that individual physical examination signs (fever, hemorrhagic bullae, and hypotension) were poorly sensitive for diagnosis of NSTI. CT had superior sensitivity and specificity to plain radiography in diagnosing NSTI, but may not be readily available in all centers, and may not be suitable for unstable patients. Finally, the LRINEC score was poorly sensitive for diagnosis of NSTI, suggesting that a low score is not sufficient to rule out the diagnosis.”


See also:

Abu El Hawa AA, Dekker PK, et al. Early Diagnosis and Surgical Management of Necrotizing Fasciitis of the Lower Extremities: Risk Factors for Mortality and Amputation. Adv Wound Care (New Rochelle). 2022 May;11(5):217-225.

Harasawa T, et al. Accurate and quick predictor of necrotizing soft tissue infection: Usefulness of the LRINEC score and NSTI assessment score. J Infect Chemother. 2020 Apr;26(4):331-334.

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Stomal necrosis

Murken DR, Bleier JIS. Ostomy-Related Complications. Clin Colon Rectal Surg. 2019 May;32(3):176-182.

Full-text for Emory users.

“Stomal necrosis has been reported to occur in up to 20% of ostomates in the immediate postoperative period ([Fig. 1]).[3] Specific risk factors for stoma necrosis include emergent operation, inadequate mobilization of the bowel, excessive mesenteric resection resulting in inadequate arterial blood supply to or venous drainage from the bowel, and constriction in the abdominal wall due to excessively small openings in the fascia, abdominal wall mesh, or skin.[10] [20] Importantly, the obese patient is seven times more likely to experience stoma necrosis than the nonobese patient.[21] Stoma necrosis is much less common for loop stomas given the dual blood supply to both the afferent and efferent limbs.”

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