Excellent antibacterial activity of Slovak honeys on bacteria mostly infecting chronic wounds.

INTRODUCTION AND AIM OF STUDY: Chronic wounds are commonly colonized by various bacterial species and colonization frequently turns into wound infection, severely impairing healing process. With increasing antimicrobial resistance, the antimicrobial treatment of chronic wounds may be extremely challenging. Rediscovery of old and forgotten antimicrobial therapeutic options, such as apitherapy, may contribute to solving the problem of incurable chronic wound infections. Aim of this study was to evaluate the antimicrobial properties of four kinds of Slovak honey from ecological beekeeping against the most common bacterial species contaminating and infecting chronic wounds, and to compare these antimicrobial activities with those of the approved medical-grade Manuka honey. The impact of honey sterilisation methods and long-lasting storage on the bactericidal activity was also examined. MATERIAL AND METHODS: Antimicrobial activity of honey was detected against 7 bacterial collection strains by broth microdilution antimicrobial susceptibility test according to EUCAST. The results were statistically analysed by Fisherꞌs exact test. RESULTS AND CONCLUSIONS: Slovak ecologically produced honey samples demonstrated an excellent in vitro antibacterial activity, superior to the monofloral medical-grade Manuka honey activity. Neither the gamma-irradiation, nor the three-year-long storage had impact on the bactericidal activity of the tested honey (Tab. 4, Fig. 2, Ref. 53).

Maggot therapy in treatment of a complex hand injury complicated by mycotic infection.

Complex injuries of the hand remain a therapeutic challenge for surgeons. We present the case of a male who suffered a devastating injury of the hand caused by a conveyor belt. The patient developed a progressive Absidia corymbifera infection of the affected soft tissues. Initial treatments with serial surgical debridement and topical and intravenous itraconazole were unsuccessful in eliminating the infection. We decided to use maggot debridement therapy in a new special design to debride all necrotic, devitalized tissue and preserve only healthy tissue and functioning structures. This maneuverer followed by negative pressure therapy allowed progressive healing. In such complex hand injuries, maggot debridement combined with negative pressure therapy could be considered to achieve effective and considerable results, although future functional morbidity may occur (Fig. 4, Ref. 18).

Gastric stimulation in treatment in type 2 diabetes mellitus.

UNLABELLED: Metabolic surgery is a dynamic field providing a wide range of new techniques. The aim of our paper is to inform about gastric electrostimulation in the treatment of type 2 diabetes mellitus. Gastric electrostimulation in type 2 diabetes mellitus treatment is performed by means of implanting Tantalus system (Metacure). When triggered by food intake, the Tantalus system generates signals for the stomach to contract. Early after the food intake, thus before the stomach distends completely, the system increases spontaneous stomach contractions. Via afferent vagal signals, these increased contractions are evaluated by the central nervous system as a sign that satiety has been reached. Three pairs of electrodes connected with a stimulator are implanted laparoscopically. The system comes equipped with a battery as well. Laparoscopically implanted system of stomach electrostimulation presents a simple and easily regulated system without disturbing the integrity of gastrointestinal tract. It is a reversible system. In accord with preliminary results, Tantalus offers a safe and effective treatment of type 2 diabetes mellitus by reducing other cardiometabolical risky factors. The operation safety is comparable with that of similar minimally invasive surgical techniques. In order to improve our understanding of diabetes mellitus pathophysiology as well as of effects of gastric electrostimulation, more trials need to be performed. The surgical diabetes treatment represents an interesting chance for patients and it might become a common technique in the future (Fig. 1, Ref. 29). KEYWORDS: diabetes mellitus, obesity, gastric stimulation, pacemaker.

Maggot debridement therapy.

AIM: To establish a maggot debridement therapy unit and assess efficacy of this method in chronic conservative non-treatable leg ulcers in patient in whom conventional therapy failed. MATERIAL AND METHODS: From August 2004 to December 2005 we treated with Maggot debridement therapy (MDT) 10 patients, 6 men and 4 women, with 13 leg ulcers treated first with conventional and then with maggot therapy. Average age of these patients was 55 years, 11 wounds were of venous and 2 of arterial origin. 7 patients had diabetes mellitus. RESULTS: 1 patient with arterial ulcers underwent supracondylar amputation, 2 patients were re-admitted for recurrent ulcers, one extremely obese patient with cardiovascular co-morbidity did not heal, but all other ulcers have been healed, cleared or minimised during 4-8 week MDT. We observed massive growth of granulation tissue and microbiological cleaning of these wounds. No adverse effects were observed. CONCLUSION: Maggot therapy was more effective and efficient in debriding non-healing leg ulcers than a conservative treatment (Fig. 3, Ref. 6).