SurgihoneyRO™

Sterile Wound Gel

SurgihoneyRO™

SurgihoneyRO™ is a cutting-edge technology, an antimicrobial wound gel utilising bio-engineered honey to deliver Reactive Oxygen™.

No gram-positive, no gram-negative or multi-drug resistant bacteria tested to date has survived the presence of SurgihoneyROTM[1].

SurgihoneyRO™ provides enhanced healing and a powerful antimicrobial action to reduce the microbial load thus removing the barriers to wound healing.

Benefits of SurgihoneyRO™

    • Kills a wide range of bacteria in vitro[1,2,3]
    • Prevents biofilm in vitro[1]
    • Fast acting antimicrobial action[2]
    • Substantially eradicates mature biofilm in vitro[4,5]

 

 

Benefits of SurgihoneyRO™ natural honey base

  • Effective debridement[6]
  • Assists the natural wound healing environment
  • Reduces pain and inflammation
  • Protects the wound bed helping to prevent pain and trauma at dressing change
  • Neutralises malodour
  • Promotes new tissue growth

 

 

 

 

 

 

 

How does ROTM in SurgihoneyROTM work?

References
1. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.
2. Dryden M. Lockyer G. Kordo S. Cooke J. Engineered honey: in vitro antimicrobial activity of a novel topical wound care treatment. Journal of Global Antimicrobial Resistance 2014. 10.1016/j.jgar.2014.03.006.
3. Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney. Journal of Hospital Infection 2014. Oct;88(2): 121-2.doi:10.1016/j.jhin.2914.07.008.Epub 2014 Aug1.
4. Perfectus Biomed report May 2017, data on file.
5. Halstead F, Use of an engineered honey to eradicate pre-formed biofilms of important wound pathogens: an in vitro study, Journal of Wound Care, 2017.
6. Dryden M, Dickinson A, Brooks J, Hudgell L, Saeed K, Cutting K. A multi-centre clinical evaluation of Reactive Oxygen™ topical wound gel in 114 wounds. Journal of Wound Care, March 2016.

SurgihoneyROTM is a single patient multi-use product which provides a clinically and cost-effective treatment regime and once opened may be used for up to 28 days.

SurgihoneyROTM  may be use for infected wounds through to healing.

 

References 
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.

 

 

SurgihoneyROTM  has been proven, in vitro, to disrupt mature biofilms[2] and hence aid wound healing[3].

Biofilms have been shown to be present in approximately 70% of chronic wounds where they reduce healing times. Single species biofilm models are typically used to test products. However, clinical biofilms are more likely to be composed of a number of microorganisms rather than a single species. The model used in this study utilised bacteria and fungi commonly found in chronic wounds to develop an infected wound model that is relevant to a clinical environment.

No viable organisms were recovered from the pre-formed 72-hour mature mixed species biofilms.

References
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.
2. Perfectus Biomed report May 2017, data on file.
3.  Halstead F, Use of an engineered honey to eradicate pre-formed biofilms of important wound pathogens: an in vitro study, Journal of Wound Care, 2017. 9. Malone, JWC, 2017.
4. M. Dryden et al. A multi-centre clinical evaluation of reactive oxygen topical wound gel in 114 wounds. JWC. 2016.

 

SurgihoneyRO™ is supported by in vitro and clinical studies and has recently been recommended for use by Public Health England. Public Health England’s guidance on common infections recognises SurgihoneyRO™ as a treatment for venous leg ulcers to reduce bacterial load and infection[2] explaining it could cut unnecessary antibiotic prescribing.

Below is a case study of a 91 year old lady, who used SurgihoneyROTM for 14 days to treat a long term leg ulcer.
(Click onto below images to enlarge them)

 

Clinical studies

Author (s) Title Publication
Dryden, M., Dickinson, A., Hudgell, L., Saeed, K. and Cutting, K.F. A multi-centre clinical evaluation of SurgihoneyRO™ in 114 wounds Journal of Wound Care, 2016, 25(3) View
Dryden, M., Goddard, C., Madadi, A., et al. Using antimicrobial SurgihoneyRO™ to prevent caesarean wound infection British Journal of Midwifery, 2014, 22(1) View
Dryden, M., Tawse, C., Adams, J., et al. The use of SurgihoneyRO™ to prevent or eradicate bacterial colonisation in dressing oncology long vascular lines Journal of Wound Care, 2014 View
Public Health England Management and treatment of common infections
Antibiotic guidance for primary care: For consultation and local adaptation
(See Page 9 for SurgihoneyRO™ recommendation)
Public Health England, 2017 View

In Vitro studies

Author (s) Title Publication
Halstead, F. In vitro activity of an engineered honey, medical-grade honeys, and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates Journal of Wound Care, 2016, 25(2) View
Halstead, F. Use of an engineered honey to eradicate pre-formed biofilms of important wound pathogens: an in vitro study Journal of Wound Care, 2017, 26(7) View
 Dryden, M. Bioengineered honey: in vitro antimicrobial activity of a novel topical wound care treatment Journal of Global Antimicrobial Resistance & Journal of Antimicrobial Chemotherapy, 2014 View
 Cooke, J. The antimicrobial activity of prototype modified honeys that generate reactive oxygen species (ROS) hydrogen peroxide  BMC Research Notes, 2015, 8(20) View
 Davies, L., Thomas, H. and Westgate, S. Multi-Species Biofilm Disruption by Two Wound Care Products Using a Colony Drip Flow Model Perfectus Biomed Ltd.,TVS conference, 2018  Coming soon

References
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.
2. Public Health England: Management and treatment of common infections: Antibiotic guidance for primary care: for consultation and local adaptation.

SurgihoneyRO™ is indicated for infected wounds, 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 & abrasions
    Burns
    Donor & recipient sites

References 
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.

SurgihoneyRO™ is applied directly to the wound bed or surgical incision site.

  • 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.

Removing SurgihoneyRO™
Residual wound gel can be removed during the normal wound cleansing regime.

Frequency of application following surgery
It is recommended to apply SurgihoneyRO™ once immediately after closure to assist healing and as an infection prevention measure. For surgical wounds at high risk of infection, e.g. abdominal surgical sites, continue to apply SurgihoneyRO™ at each dressing change.

Wear time of SurgihoneyRO™
It is recommended that SurgihoneyRO™ is applied every 72 hours (three days) and more frequently in critical wound infections to maximise effect. SurgihoneyRO™ may be used under compression bandaging for up to 7 days however potency will decrease after day 3.

 

 

 

 

References 
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.

Reactive Oxygen™ and its impact on wounds
There are many different Reactive Oxygen Species (ROS) molecules, however one most familiar to the world of wound healing is hydrogen peroxide (H2O2). ROS are a naturally occurring antimicrobial host defence mechanism of the “normal” wound healing process. ROS are molecules containing oxygen, O2, which have forcefully acquired other electrons making them highly reactive radicals with capability to destroy the cell membrane of bacteria. ROS are secondary messenger molecules utilised by various key cells in wound healing including platelets, macrophages and fibroblasts.

What is the difference between SurgihoneyRO™ and H2O2 solution?
H2O2 was traditionally used in wound care in high concentrations for its bacteria-killing properties but use was stopped as it also damaged healthy tissue. By contrast, SurgihoneyRO™ delivers low doses of H2O2 known as Reactive Oxygen™ (RO™) to the wound site, for a sustained period[2]. The level of RO™ is carefully controlled to kill bacteria yet is safe (non-toxic) to use on human tissue. In a static or non-healing wound, production of RO™ can be interrupted. SurgihoneyRO™ mimics the body’s natural production of H2O2 in the normal wound healing process.

How does SurgihoneyRO™ kill bacteria?
The RO™ in SurgihoneyRO™ kills infection causing bacteria, including MRSA, Pseudomonas, and E. coli [3,4]. The RO™ comes from the production of H2O2 when the gel is activated by moisture. In dry conditions, no H2O2 is released. H2O2 is highly unstable and rapidly breaks down into water and a single oxygen atom (H2O and O-). The reactive or unstable oxygen atom ‘steals’ electrons binding to proteins in bacteria cell walls and the walls rupture resulting in bacterial cell death[3,4,5]. SurgihoneyRO™ is an effective antimicrobial wound gel with antibiofilm activity. SurgihoneyRO™ has a medical honey gel base, bioengineered to deliver RO™, which is released in a controlled therapeutic level over a sustained period of time to combat biofilm and infection.

What are the clinical benefits of SurgihoneyRO™?
SurgihoneyRO™ helps clear infection-causing bacteria, reduces biofilm (in vitro), supports wound contraction, reduces inflammation and pain and facilitates effective debridement[6].

Which bacteria is it active against?
SurgihoneyRO™ is active against a broad range of bacteria, both Gram-positive and Gram-negative, including multi-drug resistant strains, such as MRSA and Pseudomonas aeruginosa[1,7]. Laboratory testing has demonstrated it can prevent and eradicate mature biofilms[5,8,9,10].

What is the evidence to support the use of SurgihoneyRO™?
There is evidence for treating both infected wounds and those at risk of infection. Laboratory tests demonstrated SurgihoneyRO™ kills a broad range of bacteria, is fast-acting and can both prevent and eradicate mature biofilm[1,5,8,9]. A multi-centre clinical study of 114 wounds demonstrated the wound gel is well-tolerated and shows great promise in the healing of challenging wounds[6].

How is SurgihoneyRO™ different from other medical grade honeys?
Medical grade natural honeys have healing properties. However, SurgihoneyRO™ is a bioengineered antimicrobial wound gel. It has been modified to precisely control its antimicrobial potency – a medical innovation. Its mechanism of action is delivering low, sustained doses of ROS, mainly H2O2, to the wound site. SurgihoneyRO™ has demonstrated a more potent antimicrobial activity in vitro than standard medical honeys[1]. Laboratory tests also show superior anti-biofilm action[9].

Does SurgihoneyRO™ contain Manuka honey?
No. Manuka medical grade honey has a different mode of action and does not generate the additional RO™ molecule.

How does SurgihoneyRO™ compare to other antimicrobial wound dressings?
SurgihoneyRO™ is comparable to silver- impregnated dressings in antimicrobial activity but without being toxic to healing tissue. SurgihoneyRO™ is also comparable to cadexomer iodine in preventing biofilm formation and eradicating mature biofilm[10].

Can use of SurgihoneyRO™ be painful?
For a tiny proportion of users, sterile medical honey can cause a slight stinging sensation. A multi-centre clinical evaluation of 114 wounds, showed SurgihoneyRO™ is well tolerated[6].

Can diabetics use SurgihoneyRO™?
Yes. SurgihoneyRO™ is indicated for diabetic ulcers. It is recommended glucose levels are monitored during use of honey-based products.

What secondary dressing should be used?
In the early stages, a highly absorbent secondary dressing should be used, that maintains a moist wound healing environment. Initially SurgihoneyRO™ may stimulate increased levels of exudate due to osmotic effects. As treatment progresses and infection is treated, exudate levels will decline.

Does the level of exudate affect its performance?
No. In the presence of exudate, SurgihoneyRO™ will become more dilute. However a recent in vitro study showed SurgihoneyRO™ remained a potent antimicrobial at lower concentrations[5,8].

Are there any time limits for treatment?
No. There are no contraindications associated with long-term use. However, if after two weeks there is no improvement in wound condition and microbial status, use should be reviewed. In a 114-patient study, mean use was an average 25.7 days[6].

Can SurgihoneyRO™ be used in post radiation wounds?
There is evidence in the literature of honey products being used successfully in the treatment of post radiation wounds. No formal work has been undertaken to date exploring the use of SurgihoneyRO™ for this indication.

Can SurgihoneyRO™ be used in babies?
SurgihoneyRO™ has been used successfully in the treatment of an abdominal wound infected with MRSA in a young baby in Oxford UK[11]. No formal work has been undertaken in this area.

Can a barrier protectant be used on the peri-wound area?
Yes. It is advisable to utilise barrier skin protection to prevent peri-wound maceration whilst heavy exudate levels are present.

 

References
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.
2. Dryden M Reactive oxygen species treatment in the management of wounds. Wounds UK. 2017, 13 (2).
3. Cooke J, Dryden M, Patton T, Brennan J, Barrett J. The antimicrobial activity of prototype modified honeys that generate reactive oxygen species (ROS) hydrogen peroxide. BMC Research Notes. 2015;8(1):20. Epub 2015/01/30. doi: 10.1186/s13104-014-0960-4. PubMed PMID: 25627827; PubMedCentral PMCID: PMCPMC4312449.
4. Dunnill C, Patton T, Brennan J, et al. Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process. International Wound Journal, Dec 2015.
5. Halstead F et al. Use of an engineered honey to eradicate preformed biofilms of important wound pathogens, an in vitro study. Journal of Wound Care. 2017.
6. Dryden M, Dickinson A, Brooks J, Hudgell L, Saeed K, Cutting K. A multi-centre clinical evaluation of Reactive Oxygen™ topical wound gel in 114 wounds. Journal of Wound Care, 2016.
7.  Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney. Journal of Hospital Infection 2014. 88 (2) 121-2 .doi:10.1016/j.jhin.2914.07.008.Epub 2014 Aug1.
8. Halstead F, Oppenheim B, Dryden M. The in vitro antibacterial activity of engineered honey against important biofilm-forming burn wound pathogens. Poster presentation. Federation of Infection Societies. Harrogate, 2014.
9. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates. Journal of Wound Care, 2016.
10. Multi-species biofilm disruption by two wound care products using a colony drip flow model. Date on File. 2017.
11. Data on file.

Size Product code PIP code
SurgihoneyRO™* 20g tube RO151247 407-1205
SurgihoneyRO™* 50g tube RO151248 407-1213

*SurgihoneyRO™ is single patient, multi-use and once opened can be used for up to 28 days.

References
1. F. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm producing clinical bacterial isolates. Journal of Wound Care, Feb 2016.