Effect of Polyurethane film Versus Apis Dorsata Honey spray for wound dressing following long bones fractures osteosynthesis

Abstract

Surgical site infection (SSI) following implant-related fracture osteosynthesis remains a burden and challenging for orthopaedic surgeons. Honey-based dressings have the potential to be used as potential prophylactic agents. This prospective, randomized clinical study was designed to compare the effect between the conventional polyurethane film and Apis dorsata honey spray as dressing materials after long bone fracture osteosynthesis. Forty participants with closed tibial or femoral diaphyseal fracture treated with open reduction and internal osteosynthesis with intramedullary implants or plates and screws were randomly divided into 3 groups: 16 were dressed with polyurethane film (Group A), 13 with Apis dorsata honey spray (Group B), and 11 as controls. The wounds of the two groups were dressed using a similar wound protocol, immediately (D0) and three days (D3) after the surgery. In the control group, wounds were applied with non-adhesive film only. All the wounds were evaluated on day 14 (D14) and day 42 (D42) for local complications and the effects on skin commensals. On D42, wound dehiscence and scar formation were also evaluated. Acinobacter species was isolated from one of the controls. One patient from Group A had a superficial SSI. There was no significant association between wound healing and the dressing materials used. Honey dressing had an influence in reducing the risk of hypertrophic scar formation. Other outcomes were comparable between Group A and B. Apis dorsata honey is a safe alternative dressing comparable to polyurethane film as a dressing material following long bone fracture osteosynthesis.