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Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients.

Publication ,  Journal Article
Lazarides, AL; Hamid, KS; Kerzner, MS
Published in: Foot Ankle Spec
April 2018

INTRODUCTION: Open reduction with external fixation (OREF) utilizing fine wire ringed fixators for correction of Charcot deformity has gained popularity over the past decade. Pin site infections are a well-documented complication of external fixation as well as a driver of escalating health care costs. We aimed to demonstrate the safety and efficacy of a novel method of pin site care utilizing active Leptospermum honey-impregnated dressings (MediHoney) in diabetic patients undergoing deformity correction with OREF. METHODS: Twenty-one diabetic patients with Charcot deformities of the lower extremity were prospectively enrolled and followed for pin site complications following OREF for deformity correction. Active Leptospermum honey dressings were applied at metal-cutaneous interfaces at the end of the OREF procedure and replaced weekly for a total of 8 weeks. Patients were monitored for pin site infections from the time of surgery until external fixator removal. Sixteen consecutive patients receiving standard OREF for Charcot deformities were evaluated retrospectively to serve as a control group. RESULTS: Of the 21 enrolled patients, 19 underwent OREF and followed up throughout the study period. Treated patients had a mean age of 58.5 years and mean body mass index measuring 33.3 kg/m2 as documented prior to surgery. The 15 patients with hemoglobin A1c labs drawn in the 3 months preceding surgery averaged 7.5. Fixators were removed at an average of 12.1 weeks after adequate bony healing. Of the 244 pin sites in 19 patients, 3 pin sites (1.2% of pins) in 2 patients (10.5% of patients) showed evidence of superficial infection. All infections resolved with oral antibiotics. Infection rates were significantly reduced when compared to the standard care control group. CONCLUSIONS: Pilot data in a prospectively collected case series demonstrate safety and efficacy of active Leptospermum honey-impregnated dressings when used for fine wire ringed fixator pin site care in diabetic Charcot deformity patients. Further investigation in the form of a prospective randomized controlled study is warranted to demonstrate the potential value of this novel intervention. LEVELS OF EVIDENCE: Level IV.

Duke Scholars

Published In

Foot Ankle Spec

DOI

EISSN

1938-7636

Publication Date

April 2018

Volume

11

Issue

2

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Leptospermum
  • Humans
  • Honey
  • Foot Deformities, Acquired
 

Citation

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Lazarides, A. L., Hamid, K. S., & Kerzner, M. S. (2018). Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients. Foot Ankle Spec, 11(2), 117–122. https://doi.org/10.1177/1938640017709907
Lazarides, Alexander L., Kamran S. Hamid, and Michael S. Kerzner. “Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients.Foot Ankle Spec 11, no. 2 (April 2018): 117–22. https://doi.org/10.1177/1938640017709907.
Lazarides AL, Hamid KS, Kerzner MS. Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients. Foot Ankle Spec. 2018 Apr;11(2):117–22.
Lazarides, Alexander L., et al. “Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients.Foot Ankle Spec, vol. 11, no. 2, Apr. 2018, pp. 117–22. Pubmed, doi:10.1177/1938640017709907.
Lazarides AL, Hamid KS, Kerzner MS. Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients. Foot Ankle Spec. 2018 Apr;11(2):117–122.
Journal cover image

Published In

Foot Ankle Spec

DOI

EISSN

1938-7636

Publication Date

April 2018

Volume

11

Issue

2

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Leptospermum
  • Humans
  • Honey
  • Foot Deformities, Acquired