www.advancis.co.ukwww.advancis.co.uk

Activon Manuka Honey®

The natural choicefor wound management...

Why Manuka honey?The properties of Advancis Manuka honey provide a combination of beneficial wound healing effects not found in other types of dressings. Advancis Manuka honey has an osmotic effect that helps to de-slough and debride necrotic tissue1 that can harbour bacteria and impede wound healing. There is a marked reduction in odour2,4 when Advancis Manuka honey is applied to a malodorous wound. Advancis Manuka honey will protect the wound bed and provide a moist wound healing environment known to be beneficial to wound healing and promote faster healing3.

Antibacterial honeyAdvancis Manuka honey is made from the nectar gathered from Manuka plants in New Zealand, which are part of the Leptospermum species commonly known as the teatree family. Honey from this plant source has been found to have a unique antibacterial property not found in honey from other floral sources. The antibacterial property of honey from other floral sources is de-activated by an enzyme called catalase which is found naturally in wounds. Advancis Manuka honey’s main antibacterial property is derived from the nectar of the plant which is unaffected by catalase and remains active at very low concentrations. This is known as the unique Manuka factor and the potency of the honey is compared to the antibacterial potency of diluted Phenol. The unique Manuka Factor of Advancis Manuka honey is measured at +12 and is typically 14, equivalent to a 14% phenol dilution.

An educational DVD is available from Advancis Medical of Professor Peter Molan’s presentation:“The wound healing process - and how honey helps it”

To get a copy email info@advancis.co.uk

Advancis Manuka honey is a broad spectrum antibacterial product and effective against most wound invading bacteria e.g. staphylococcus aureus, pseudomonas auriginosa, MRSA and VRE.

Properties of Advancis Manuka honey• Effective debridement capabilities for faster wound bed preparation

• Deodorises wounds, positively impacting on a patient’s quality of life

• Maintains a moist wound healing environment, facilitating faster healing of chronic wounds

• Extensive range of Advancis Manuka honey dressings, allowing the right dressing selection for each wound type

• In-vitro clinical trials have demonstrated that low concentrations of Advancis Manuka honey prevented biofilm formation in MSSA, MRSA and VRE.5

• Honey is non-cytotoxic and is a completely natural substance.

Advancis Medical bring the benefits of 100% Manuka honey into a versatile suite of wound management tools that enable you to choose the right dressing for every phase of wound healing.

Guidelines for dressing selection using Advancis Medical Manuka honey products

Necrotic Necrotic/Sloughy Sloughy Sloughy/Granulating Granulating/Epithelialisation Epithelialisation

Activon Tube® / Algivon® / Algivon Plus® / Algivon Plus Ribbon® Activon Tulle® Actilite®

The wound healing progression model

This graph shows the wound healing process and the stages where each of the Manuka honey dressings are most suitable/effective.

Necrotic Sloughy Granulating EpithelialisingDry

Debride

Absorb

Algivon Plus Ribbon®

Algivon Plus®

Activon Tube®

Algivon®

Activon Tube® / Algivon® / Algivon Plus® / Algivon Plus Ribbon®®

Activon Tulle®

Actilite®

Protect & Hydrate

Wound exudate

Wet

The natural choicefor wound management...

Activon Tulle®

Knitted viscose mesh impregnated with 100% Manuka honey

Activon Tube®

100% Medical Grade Manuka honey

Algivon®

Alginate dressing impregnated with 100% Manuka honey

Actilite®

Non-adherent viscose net dressing coated with 99% Manuka hone

and 1% Manuka oil

Product descriptionActivon Tube® contains 100% Medical Grade Manuka honey with no additives. Our Manuka honey is filtered and sterilised, making it suitable for application to wounds. Manuka honey will de-bride and de-slough, eliminate odours and provides a moist wound healing environment. Activon Tube® is ideal for debriding necrotic tissue, or for applying additional honey to a dressing where further bacterial resistance is needed. Great for using in cavities, just wash away with saline solution.

Dressing features

Product descriptionActivon Tulle® is a knitted viscose mesh primary dressing impregnated with 100% Medical Grade Manuka honey. Activon Tulle® creates a moist healing environment and effectively eliminates wound odour whilst providing antibacterial action.

Activon Tulle® is ideally suited to debriding and de-sloughing shallow wounds or where the exudate levels have started to decrease.

Dressing features

Product descriptionAlgivon® is an alginate dressing impregnated with 100% Medical Grade Manuka honey. The alginate fibres enable a sustained, slower release of honey.

Algivon® is an ideal choice for wetter wounds as the alginate has a small capacity to absorb, meaning the honey isn’t washed away with exudate therefore staying at the wound site for longer. The dressing is very soft and conformable, ideal for cavities and debriding and de-sloughing large areas of necrotic and sloughy tissue.

Dressing features

Product descriptionActilite® is an inexpensive and highly effective broad spectrum antimicrobial dressing containing 99% Manuka honey and 1% Manuka oil for use on low to moderate exuding wounds

The dressing is designed to protect a wound, promote healing and allow the passage of exudate. It is an ideal choice for epithelialising wounds that are perceived to be at risk of re-infection.

Dressing features

Activon Tube® contains 100% pure Manuka honey with no additives

Deodorises wounds, positively impacting on a patient’s quality of life

Maintains a moist wound healing environment, facilitating faster healing of chronic wounds

Activon Tube® is not absorbed into the blood stream, meaning it can be safely used on diabetic patients

Can be used in conjunction with a wide range of secondary dressings

Activon Tulle® is a 2 in 1 sterile dressing; Manuka honey with a primary dressing

Allows exudate to pass through the dressing on wounds with low to moderate levels of exudate

Activon Tulle® can be cut to size, increasing patient comfort and resulting in better peri-wound skin condition

Activon Tulle® can be placed on the wound either side up, eliminating incorrect dressing application

The only absorbent alginate dressing delivering 100% pure Manuka honey

A totally natural broad spectrum antimicrobial dressing

Efficient debridement solution for sloughy and infected wounds

Slower, sustained release of honey reduces pain sensation experienced by some patients

Light, flexible, low profile knitted net dressing ideal for use under compression

Lower concentration of honey reduces potential for initial drawing sensation

Can be used in combination with TNP

Non-adherent, reducing pain and trauma

Can be cut or folded to the shape of the wound

Lightweight versatile dressing solution to be used when there is a clinical sign of infection and to prevent re-infection

Case Reports

Mrs H is aged 64 years and presented to District Nurses with bilateral leg ulcers and following Doppler examination this was found to be venous in origin. Mrs H was having both legs re-dressed 3 times a week with many dressings but was non-compliant and complained of severe pain and discomfort. The patient was returning to clinic every day (twice some days) complaining of pain, offensive odour and excessive exudate.

There were many failed attempts at treating this lady with various antimicrobials and dressings, and advice given on a healthy diet and exercise with which the patient did not comply. Mrs H’s GP and nursing staff spoke to her about the possibility of surgical intervention maybe amputation of both legs, this was a shock to the patient. Fortunately we were introduced to the Activon Tube® and Algivon® by the Advancis Medical representative. The clinical staff elected to use Activon Tube® and Algivon® as a last attempt to resolve this patient’s condition. We applied the products to the patient and after two applications the odour had decreased, the exudates were slightly less and there was no pain on removal.

The patient saw an improvement and therefore began to comply with the treatment regime. As a result of this Mrs H began gentle exercise and changed her diet, which improved her condition holistically. We have continued this treatment 3 times a week for almost 6 months and have now almost healed the ulcers. The patient has now been measured for support hosiery.

Mrs H is now fully compliant with treatment, has lost 2 stones in weight and has a much healthier life style.

The use of Activon Tube® and Algivon® on a non-compliant patient with chronic venous leg ulcersAnn Smith RGN District Nursing Sister - Stocksbridge, Sheffield

Anti-bacterial – kills harmful bacteria

Anti-inflammatory

Eliminates odours without masking them

Osmotic effect, drawing harmful tissue away from the wound bed

Maintains the ideal moist wound healing environment

Ability to absorb exudate

Reinforced to maintain dressing integrity

Anti-bacterial – kills harmful bacteria

Anti-inflammatory

Eliminates odours without masking them

Osmotic effect, drawing harmful tissue away from the wound bed

Maintains the ideal moist wound healing environment

Ability to absorb exudate

Reinforced to maintain dressing integrity

Shaped to fit easily and effectively within cavities and sinuses

Algivon Plus Ribbon®

Reinforced alginate ribbon impregnated with

100% Manuka honey

Algivon Plus®

Reinforced alginate dressing impregnated with 100% Manuka honey

Product description

Algivon Plus® is a reinforced, soft alginate dressing impregnated with 100% Medical Grade Manuka honey. The strengthened alginate fibres enable a sustained, slower release of honey whilst maintaining the integrity of the dressing.

Algivon Plus® is an ideal choice for wetter wounds as the alginate has a small capacity to absorb, meaning the honey isn’t washed away with exudate, therefore maximising wear time and effectiveness. The dressing is very soft and conformable, ideal for debriding and de-sloughing large areas of necrotic and sloughy tissue.

Dressing features

Product description

Algivon Plus Ribbon® is the same reinforced, honey impregnated material as Algivon Plus® but is in an easy to use ribbon shape. The ribbon features the same strengthened alginate fibres meaning it enables a slower release of honey at the wound site.

Algivon Plus Ribbon® is very soft and conformable, shaped for easy application within cavities and sinuses meaning the wound can be easily packed for direct contact with the entire wound site. The upgraded alginate allows for dressing removal in one piece.

Dressing features

Jason is a 39 year old gentleman who was originally diagnosed with non-Hodgkin’s lymphoma in 1994 following numerous operations for a non-healing abscess on his buttock which when biopsied finally confirmed the diagnosis. In the following years he had courses of radiotherapy and trips to London for various alternate treatments which also included the policies of the Bristol Cancer Centre (dietary and relaxation). He had declined any offer of chemotherapy.

Jason’s disease had progressed to lymphoedema of his left arm, a large fungating tumour on his left shoulder and multiple dry cutaneous lesions on his left lateral chest wall, left arm and around his left shoulder when he was referred to the district nurse team. He had declined referral to the local hospice and palliative care team and following admission for IV antibiotics for an episode of AIE (Acute Inflammatory Episode) of his lymphoedema declared he would not have any further antibiotics.

On examination he was found to have an excess of dry scales over his anterior chest wall, areas of erythema, multiple small lesions, grade II lymphoedema and a grade II lesion with a large area of devitalized tissue, copius exudates and odour. He was pale and cachexic but denied being anaemic, the slightest exertion caused shortness of breath and he appeared weak and tired. The tumour and lymphoedema had caused obvious distortion and subluxation of his left shoulder causing physical problems with movement and dressing. Initially his treatments consisted of a hydofibre, a carbon pad, a silver impregnated charcoal dressing, surgipads (20cm x 40cm) six a day, and tubifast (a haemostat was available if bleeding should occur) but it was obvious that these dressings did not have the capacity to contain or manage the wound exudates or odour. On consultation Jason denied pain completely, but he was never able to tolerate any compression even crepe for his lymphoedema. He stated that the odour and exudates were to him the most distressing problems.

He then requested that honey be tried. Collier (1997) suggests that it is important to ensure that individuals needs and wishes are addressed to promote autonomy and quality of life. Activon

Tulle® (supplied by Advancis Medical) was therefore applied with an absorbent pad as a secondary dressing (Eclypse® supplied by Advancis Medical).

Jason’s dressings continued to be changed daily. The dry crusts were treated with Dermol 600 and Dermol 500. Jason although asked verbally denied any drawing or stinging sensation when the Activon Tulle® was applied. Despite the location of the tumour the dressing was easy to apply and easy to remove. Although observations have recorded that honey poses problems when liquefied (Lawrence 1999). Both Jason and the district nurse team scored the odour on assessment as strong despite the use of carbon. After one week the odour score was down to moderate and within the second the odour score went from slight to no odour. For Jason it enabled him to feel part of his family again and not feel ashamed. During the second week the wound had self debrided and exudates management continued to improve using Eclypse®. From six surgipads (20cm x 40cm) per day the padding was reduced to one - the Eclypse®. This was held in place using a made to measure retention vest (available from SDH) which Jason could manage despite his physical problems. No maceration was noted and it was felt without the Eclypse® dressing changes would have increased to two/three times a day.

A final thought that can only begin to sum up what it must be truly like to live with this disease. ‘Can we begin to imagine what it must feel like for a patient to see part of his or her own body rotting and to have to live with the offensive smell from it, see the reaction of visitors (including doctors and nurses) and know that it signifies a lingering death’. Doyle (1980)

Activon Tube® and Activon Tulle® in the treatment of a fungating tumourCaroline Farrant, Wound Care Specialist Nurse. South Wiltshire Primary Care Trust (SWPCT)

Mrs X a 34 year old woman was injured when she had applied lice lotion to her hair and then went too near to a naked flame. This caught fire and she was left with 4% Total Body Surface Area (TBSA) burns to the right side of her face, neck and scalp.

These were predominantly deep dermal in nature with a small 0.5% TBSA that was full thickness. Surgery to this area is not normally undertaken lightly as scarring can be significant, and it is difficult to recreate anatomical structures such as the ear. Initially she was treated with Atrauman and Flamazine which is standard practice, but as the wound was deeper and there was risk of more significant scarring, it was decided to treat her conservatively with Algivon®.

The patient found the dressing comfortable and soothing as well as easy to remove. The dressing was relatively easy to apply and once it had warmed up, it became very conformable and easy to use.

The dressing was changed every 2-3 days minimising nursing time and trauma to the wound bed. The promotion of autolytic debridement prevented the need for surgery, whilst maintaining an antimicrobial environment. Staff found the dressing easy to apply and remove and no adverse effects were noted.

The use of Algivon® on a burn to the face, neck and scalpJacky Edwards - Clinical Nurse Specialist - Manchester Burns Service, University Hospital of South Manchester NHS Foundation Trust

Name Stock code PIP code Size No. per box

Activon Tube® CR3830 319-3729 25g 12

Activon Tulle® CR3761 304-0631 5cm x 5cm 5

Activon Tulle® CR3658 304-0623 10cm x 10cm 5

Actilite® CR4281 379-3759 5cm x 5cm 10

Actilite® CR3849 335-4917 10cm x 10cm 10

Actilite® CR3852 335-4925 10cm x 20cm 10

Algivon® CR3831 319-3711 5cm x 5cm 5

Algivon® CR3659 319-3703 10cm x 10cm 5

Algivon Plus® CR4230 374-9496 5cm x 5cm 5

Algivon Plus® CR4225 374-9512 10cm x 10cm 5

Algivon Plus Ribbon® CR4231 374-4653 2.5cm x 20cm 5

Actibalm® CR3955 347-1224 10g 20

Ordering codes and sizes

Frequently asked questions...

Do honey dressings increase wound exudate levels?

Yes, this is due to osmotic action which is an important and integral part of how honey works. Ensure secondarydressing can cope with the increased exudate level. The high level of exudate should subside after time.

Does it sting?

A minority of patients report a stinging pain upon application. This is due to the acidic nature of honey. It is not indicative of damage and should wear off in a few hours once the nociceptors/nerve endings have adjusted to the change in wound pH.

www.advancis.co.uk

What secondary dressing do you recommend?

It depends upon the level of exudate. Low to moderate exuding wounds we recommend the Advazorb® range of foam dressings. For medium to high exudate, we recommend Eclypse® super absorbent dressings.

Can you use Advancis Manuka honey on diabetic patients?

Yes, there are no reports of our honey affecting blood sugar levels as the honey is not absorbed into thebloodstream. We do advise monitoring patients with diabetes6.

References1. Molan. P December 2001 Honey as a topical antibacterial agent for treatment of infected wounds. Available: http://www. worldwidewounds.com/2001/november/Molan/honey-as-topical-agent.html

2. S Natarajan, D Williamson, J Grey, KG Harding and RA Cooper (2001) Healing of an MRSA-Colonized, hydroxyurea induced leg ulcer with Honey. Journal of Dermatological Treatment (2001) 12, 33-66

3. Dunford C et al (2000) The use of honey in wound management. Nursing Standard, 15,11,63-68 November 2000

4. Thomas P 1998 April 1998 Odour Absorbing Dressings: A comparative laboratory study. (On-line) Available: http://www.worldwidewounds.com/1998/march/Odour-Absorbing-Dressings/odour-absorbing- dressings.html

5. Cooper R et al (2011) Inhibition of biofilms through the use of Manuka honey. Wounds UK, 2011, Vol 7, No1

6. Kirby P et al (2009) Do honey impregnated dressings affect glycaemic control. The Diabetic Foot Journal, Vol 12, No 4

MAR205/r8

Scan me for more information

Advancis Medical is a trading name of Brightwake LtdLowmoor Business Park, Kirkby-in-AshfieldNottingham, NG17 7JZ, EnglandTel: +44 (0)1623 751500 | Fax: +44 (0)871 264 8238 | Email: info@advancis.co.uk