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Overview

SurgihoneyRO is an antimicrobial wound gel approved for clinical use in the UK, Europe and Canada. It has a EU CE mark and proven safety and efficacy profile.

The topical wound gel has its roots in discoveries made by founder Ian Staples and research groups in Ireland and the UK which led to novel insights into the role of Reactive Oxygen® as a natural, antimicrobial defence mechanism.

Founders Ian and Stuart Staples with consultant microbiologist Dr Matthew Dryden.

It all began with an observation of nature. What is the secret of the honeybees’ success in protecting their prized honey hoard to feed them over winter? Conditions are ideal for fermentation: nectar is a weak sugar solution, yeast is naturally present and bees forage in warm spring and summer months. What stops it turning into alcohol?Scientists concluded protection comes initially in the production of hydrogen peroxide in nectar, nature’s own antimicrobial solution. As hydrogen peroxide, a reactive oxygen species, breaks down, free oxygen radicals are formed deadly to microbes. Fully ripened honey has a low hydrogen peroxide content as its high sugar and low water content (high osmolarity) is enough to stop fermentation.What’s more the researchers invented a way to precisely control or engineer this natural characteristic in honey. The result is SurgihoneyRO, a bioengineered medical honey wound gel that exerts its antimicrobial effect primarily through the slow release of ROS, mainly hydrogen peroxide, to the infection site.Honey has been used for wound healing for centuries. However, there is a huge variation in the antibacterial potency of natural honeys depending on the floral source, geographical location and time of harvest. The efficacy will vary.

SurgihoneyRO has undergone a unique proprietary process that ensures a standardised and reproducible antimicrobial effect due to the sustained release of Reactive Oxygen® when it is diluted with wound exudate. It is not reliant on a single floral source for its potency and can be produced in large quantities. This is a unique innovation.

SurgihoneyRO is sourced from honey with stringent controls to make sure it is ultra-pure and free from antibiotics and pesticides. Gamma irradiation is used to destroy any potential microorganisms without loss of its antimicrobial potency.

Produced by Matoke Holdings Ltd, SurgihoneyRO is the first Reactive Oxygen® agent to reach clinical use.


How to apply

SurgihoneyRO is applied directly to the wound bed or surgical incision site.  To ensure optimum results please follow the following guidelines:

  • Cleanse the wound as per local guidelines
  • Apply 2mm thickness directly to the wound bed. Alternatively, SurgihoneyRO can be applied to an inert wound contact or secondary dressing then placed on the wound bed
  • Select an appropriate secondary dressing for exudate level and to maintain moist wound healing environment
  • A tube of SurgihoneyRO may be used on a single patient, multiple times, for up to 28 days

It is recommended that SurgihoneyRO™ is applied every 72 hours (3 days) and more frequently in critical wound infections to maximise effect.

  • For critically infected wounds, it is recommended that SurgihoneyRO is applied daily then reduce to alternate days, then to every 3 days over the first 2 weeks (subject to individual clinical scenario). If there is no improvement in the wound condition and microbial status use should be reviewed
  • For surgical incision sites, it is recommended to apply SurgihoneyROonce immediately after closure to assist healing and as a secondary infection prevention measure

SurgihoneyRO may be used under compression bandaging for up to 7 days however potency will decrease after day 3.

With a low therapeutic dose of H202 there are no contraindications associated with long term use and it is non-toxic to healthy tissue. It may be used on children.

Indications for use

SurgihoneyRO™ is a safe and effective multi-action product without the drawbacks of other antimicrobial wound dressings. The bioengineering ensures a consistent level of therapeutically active Reactive Oxygen® which aids the antimicrobial activity for up to 3 days.

SurgihoneyRO™ is indicated for infected, chronic and acute wounds through to wound healing.

Chronic wounds including:-

  • Diabetic foot ulcers
  • Pressure ulcers
  • Leg ulcers

Infected wounds

Acute wounds including:-

  • Surgical wounds
  • Traumatic wounds, cuts and abrasions
  • Burns
  • Donor and recipient sites

Why is it different?

Medical-grade honey is an established topical treatment for wounds and burns due to its antimicrobial and wound healing promotion activity. It provides rapid autolytic debridement, reduces odour, and decreases wound-related pain and bio-burden1. Honey works in a different way to antibiotics – it is hypersomolar, restricting the availability of water to bacteria and dehydrating bacteria by osmosis.

Natural honeys vary hugely in their antimicrobial properties and there is little consistency in antimicrobial effects because there can be no control over nectar source, sugar content and other contaminants in entirely natural products. Many medicinal honeys are based on Manuka honey, which is one of the more antimicrobial natural honeys.

Different mechanisms of action have been suggested for the antimicrobial effects of honey, but the main ones are the high-sugar concentration, H2O2, the 1,2-dicarbonyl compound methylglyoxal (MGO), the cationic antimicrobial peptide bee defensin-1 and the low pH2. Some patients may experience momentary stinging or a drawing sensation when using honey therapies due to its autolytic debriding properties and the drawing of fluids by osmosis away from the wound3.

SurgihoneyRO™ has all the natural healing-inducing, desloughing and tissue regenerative properties of the honey carrier, but it has been bioengineered to deliver precisely controlled level of Reactive Oxygen®. When SurgihoneyRO™ comes into contact with moisture, Reactive Oxygen® is instantly released and sustained for over 72 hours4.

SurgihoneyROis a fast acting, effective antimicrobial.

The speed of cidal activity is shown by the time-kill curves to be extremely rapid, by 30 mins the bacteria had fallen 1,000-fold. All bacteria were killed within 48 hours4.

References

Reactive Oxygen®

SurgihoneyRO™ is the first published, antimicrobial wound dressing that has been tested against the 12 priority MDR bacterial strains, and has been shown to be effective against almost all these organisms1.

The term reactive oxygen species (ROS) describes highly reactive molecules containing reduced oxygen or oxygen atoms with extra electrons. Members of the ROS family include superoxide anion O22, peroxide O22, hydrogen peroxide H2O2.

ROS are naturally occurring in the body. Basal ROS levels maintain normal cell functioning and homeostasis2, while increased amounts induce a cell-mediated antimicrobial defence response3.

ROS are part of the innate immune response, and play a critical role in wound healing and infection control at the wound site4. They are released within minutes of epithelial injury, signalling rapid recruitment of leukocytes5. ROS directly damage microbes that invade tissues6. In wound healing, ROS are secondary messengers to many immunocytes and non-lymphoid cells, and regulate angiogenesis, haemostasis and tissue repair7.

Reactive Oxygen® is the antimicrobial mechanism for SurgihoneyRO™. In contact with moisture, SurgihoneyRO™ releases Reactive Oxygen®.

Reactive Oxygen Diagram

In vitro studies have shown that Reactive Oxygen® at close to naturally occurring levels:

  • Stimulates proliferation of human fibroblasts and vascular endothelial cells5,13
  • Stimulates angiogenesis via vascular endothelial growth factor (VEGF) signalling14
  • Promotes keratinocyte cell migration and proliferation15

A controlled and sustained level of H2O2 that is non-harmful and non-toxic to surrounding tissue, is a therapeutic opportunity for wound care. SurgihoneyRO™ does this through the release of Reactive Oxygen®.

Research
Scientists from the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre, the research arm of the NHS, demonstrated SurgihoneyRO is highly effective at tackling a wide variety of bacterial biofilm found in chronic wounds in vitro.

“Given the threat posed by antimicrobial resistance and the ever-increasing need to find new solutions to treat infections, SurgihoneyRO has real potential as a new wound care agent to kill bacteria and disrupt biofilm.” – Fenella Halstead, Clinical scientist, National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre

SurgihoneyRO™ has been successfully used for infection prevention, eradication of MDR bacterial strains and prevention of surgical site infections and intravascular line care in vivo 15,16,17.

The Reactive Oxygen® released by SurgihoneyRO™ is a broad-spectrum antimicrobial against wound-relevant MDR bacterial strains and has been shown to prevent and disrupt and eradicate mature biofilm.

SurgihoneyRO™ presents one option against the growing global issue of antimicrobial resistance.

 

 

References

What is SurgihoneyRO™?

SurgihoneyRO™ is a cutting-edge technology, an antimicrobial wound gel utilising bioengineered honey to deliver Reactive Oxygen® (RO™).

SurgihoneyRO™ provides enhanced healing and a powerful antimicrobial action to reduce the microbial load thus removing the barriers to wound healing. Unlike other medical grade honeys, SurgihoneyRO™ has been bioengineered to enhance and precisely control its antimicrobial potency.

  • Kills a wide range of bacteria in vitro1,2,3
  • Prevents biofilm in vitro1
  • Fast acting antimicrobial action2
  • Substantially eradicates mature biofilm in vitro4,5
  • Effective against multi drug-resistant microorganisms commonly found in chronic wounds6
  • Effective debridement
  • Assists the natural wound healing environment and promotes new tissue growth

SurgihoneyRO™ is the only published, proven antimicrobial wound dressing tested against the WHO priority pathogens6.

References