Out with the Old, In with the Old

This morning I cleaned out my file boxes of veterinary articles that I have been collecting for the last 14 years. We’re in the process of remodeling a couple of rooms in our house. The impending move of my office seemed like a good opportunity to weed through those papers that I’d been hauling around for so long but rarely referred to anymore because of the power of online resources like PubMed.

I couldn’t toss everything without first looking for hidden gems though (there were a few), but what I found most interesting was how things have changed in veterinary medicine since I started clipping articles back in the late 1990s. I saved information that was brand new at the time, but now a lot of it seems almost old hat (e.g., using trilostane to treat Cushing’s disease in dogs). I remember one of my professors in veterinary school telling us that half of what we learn today will be obsolete in five years. I think his numbers might be a little overstated, but the fact that what is "cutting edge" changes with mind numbing speed is certainly true.

But not all old information is outdated. Two of the articles that I clipped back in 2002 talked about the benefits of using honey and sugar to treat large, contaminated wounds. According to the authors: "The use of honey to treat wounds dates back to 2000 BC," while "the use of finely powdered sugar to clean wounds was first reported by Scultetus in 1679."

Doctors are revisiting the use of these "old school" (to say the least) forms of therapy because they are cheap and effective. When a companion animal has lost a significant amount of skin and subcutaneous tissue to a fall from the back of a pickup truck — burns, aggressive infections, etc. — the cost of modern wound dressings can be prohibitive. Sugar and honey are cheap enough to save pets that might otherwise be euthanized because of the costs associated with their treatment.

Sugar and honey work because of the way in which they change the local wound environment. When sugar is applied to a lesion, it draws water out through the tissues and dissolves. The resulting sugar solution is so concentrated that it inhibits the growth of bacteria. Honey works in the same way but also produces hydrogen peroxide that kills bacteria. In addition, sugar and honey both draw white blood cells to the area that work to clean the wound, speed the sloughing of dead tissue, and aid in the formation of a protective layer on the wound’s surface. Overlying bandages need to be changed and sugar and honey reapplied frequently to maintain their healing properties, but this is no different from what needs to be done when using commercially prepared wound dressings.

Sometimes staying on top of the advances in veterinary medicine feels like a Sisyphean task. I’m sure a lot of what I am currently learning will still be relevant five years from now, but I doubt it will have the staying power (over 4,000 years!) that honey has had.

Dr. Jennifer Coates

Sources:

Wound Management Using Sugar. Mathews KA, Binnington, AG. Compendium. Vol.24, No. 1, Jan. 2002 41-50.

Wound Management Using Honey. Mathews KA, Binnington, AG. Compendium. Vol.24, No. 1, Jan. 2002 53-60.

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