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Monthly Aesthetic Treatments: Unlock the Anti-Aging Benefits of the Bio-Syntha C Peel

When it comes to maintaining youthful, radiant skin, incorporating professional treatments into your routine can make all the difference. BioMedical Emporium’s Bio-Syntha C Peel is a powerhouse of pure molecular Vitamin C exposure, delivering unparalleled anti-aging and skin-brightening benefits. Discover why this treatment is a must for anyone looking to rejuvenate their skin. Why is Vitamin C Amazing for Your Skin? Vitamin C is a skincare superhero, and the Bio-Syntha C Peel harnesses its full potential to transform your skin. Here’s why Vitamin C is so effective: Improves Skin Texture and Tone: By stimulating collagen production and renewing skin cells, this treatment leaves your skin smoother and more even. Protects Against Sun and Environmental Damage: Vitamin C acts as a powerful antioxidant, buffering your skin against harmful UV exposure and environmental pollutants. Boosts Skin Immunity: High concentrations of antioxidants in the Bio-Syntha C Peel strengthen your skin’s natural defenses, keeping it healthier over time. Treats Hyperpigmentation: This treatment lightens dark spots and speeds up the process of evening out skin tone, tackling stubborn pigmentation issues. Anti-Aging and Brightening Effects: The profound brightening and anti-aging qualities of this peel make it a favorite for those seeking a youthful glow. What to Expect During and After the Treatment The Bio-Syntha C Peel delivers incredible results, but it’s important to know what to expect: Downtime: There will be a recovery period of 3 to 6 days. During this time, your skin may peel, revealing the brighter, rejuvenated layers underneath. Pruritic Effect: Due to the high potency of pharmaceutical-grade raw materials, you may experience a slight itching sensation. No Sun Exposure: Sun protection is critical following this treatment. To enhance results, the peel is concluded with BioMedical Emporium’s Retinol Night (optional and suitable for advanced treatments). Trust the Experts Every accredited BioMedical Emporium therapist is professionally trained to administer the Bio-Syntha C Peel and manage any adverse reactions effectively. Our therapists ensure your comfort and provide guidance throughout your skincare journey. To find a certified therapist near you, click the “Find a Stockist” button on our website. You’ll be welcomed into the world of BioMedical Emporium with expert care and personalized advice. Glow Brighter Every Week Replenish and rejuvenate your skin weekly with the BioMedical Emporium Bio-Syntha C Peel. This treatment ensures your skin remains radiant, healthy, and protected against environmental stressors. With its remarkable anti-aging and brightening effects, you’ll see noticeable improvements in skin tone and texture. Ready to Transform Your Skin? Book your BioMedical Emporium Bio-Syntha C Peel today and experience the powerful benefits of pure molecular Vitamin C exposure. Visit our website to find an accredited therapist or click “Find a Stockist” to connect with a professional near you. Let BioMedical Emporium guide you toward your most radiant, youthful skin yet!

Case Review: Diversified Wound Management with A Dual-Purpose Wound Occluding Honey Based Ointment

 Abstract The correct and effective management of wounds remains challenging within the wound care discipline even though much effort and attention has been directed toward novel technologies and advanced approaches. As wound healing takes place in four stages, the selection of the appropriate treatment, depending on the respective stage on the patients’ wound, is crucial. In addition, identifying the type of wound might be difficult in some cases, which in combination with the aforementioned further complicates appropriate wound management. This article discusses a single product wound management, by means of case studies, in an attempt to describe a simplified and possibly cost-effective way to manage wounds effectively. Introduction The efficient and proper management of wounds remains a clinical problem, frequently causing morbidity and mortality due initial and delayed complications. Consequently, a substantial amount of research has been conducted to identify and continuously develop novel therapeutic approaches and technologies for the management of acute and chronic wounds.1 The development of new approaches however requires understanding the physiological trajectory of normal wound healing,2 described as the phases of hemostasis, inflammation, proliferation, and remodeling. The wound healing process is a complicated and intricate process. The stages of wound healing do not occur in isolation as considerable overlapping transpires between the stages. Wound healing, sometimes called the healing cascade, is generally described in four distinct phases. Homeostasis: When incurring a wound, the first phase of the wound response is concerned with maintaining homoeostasis within the body. Most wounds, even superficial shallow wounds, lead to damage to the vascular system. To manage blood loss and reduce the possibility of infection spreading throughout the body, circulation platelets within the blood begin to form a fibrin clot, which seals the wound site. Additionally, vasoconstriction primarily occurs around the wound site as a means of isolating the wound site. However, this is followed by vasodilation, so the required cells can be recruited to the wound site. Growth factors are released from damaged cells, and those around the wound site upregulates a rapid inflammatory response. Inflammation: Immune cells, such as neutrophils and macrophages, are attracted by factors released from the wound site and begin to accumulate, travelling through the circulatory system. These cells are responsible for the removal of debris and killing of bacteria that easily colonize the wound site and prepare the wound for the proliferative / remodeling phase. Proliferation: The proliferative phase can be divided into four phases; in the case of superficial wounds the initial two steps may not occur: Re-vascularisation: New blood vessels are formed around the wound site to provide the cells and nutrients essential to remodel the wound. • Granulation: Fibroblasts drawn to the wound site rapidly form temporary extra cellular matrix, comprised of collagen and fibronectin, upon which the epidermis is reconstituted. Re-epithelialization: The mechanism of re-epithelialization is poorly understood. It’s thought that surviving epithelial cells around the edges of the wound bed become more motile and stretch to cover the wound site. When a continuous epidermis is formed, the cells lose this motility and start to divide. Contraction: Re-epithelization is believed to occur simultaneously with contraction, where myo-fibroblasts recruited around the wound site pull against each other to contract and reduce the dimensions of the wound. Remodelling: Following closure of the wound, remodelling can occur. The epidermis proliferates and returns to its normal character; fibroblasts and immune cells which were recruited to the site are degraded; and therefore, the temporary extra cellular matrix that was laid down is remodelled into a stronger, more permanent structure.3 These four highly programmed, integrated and overlapping phases, are required to occur in a specific time frame and sequence, for successful wound healing to occur.4 Numerous factors can cause a disruption or affect one or more of these stages,1 resulting in a non-healing chronic wound or delayed wound healing.4 The latter has through history been a global concern due to the distress and discomfort it causes to the patient.5 Subsequently to the rate of wound healing and especially in aesthetically sensitive locations the degree of scarring post wound healing become an important factor to consider due to the life-long psychological and or functional implications it may have on the patient.6 Although novel wound care techniques such as negative pressure wound therapy (NPWT) has been developed and implemented with great success in the past two decades, certain individual patient related factors can necessitate the consideration of other therapies. A study performed by Fagerdahl5 highlighted patient experiences with the use of negative pressure wound therapy, these areas included i.e. the affect this therapy had on the patients personal environment (physical, mental, social and spiritual aspects). Other important factors to either manage or consider is existing infection or the possibility of occurring infection, as a wound causes the skin to be impaired and therefore highly susceptible to bacterial infiltrations. By preventing or treating these infections effectively, it can significantly improve the wound healing,7 however accomplishing this task has become a difficult endeavor in the modern age, due to the increasing amount of antibiotics that because of bacterial resistance is rendered effective. Hence, exploring alternative therapies becomes increasing crucial, and although many exists, implementation thereof may be challenging.8 Factors that affect wound healing The time required for a wound to progress duffers dramatically on local and systemic factors as outlined in the Table 1 below. Differentiation between acute and chronic wounds Acute wound An acute wound occurs on a site with normal injury at a specific time from a known mechanism (burn, cut, etc.). Its depth is variable depending on the type of trauma. Acute wounds usually heal rapidly and uneventfully. An acute wound can become chronic (longstanding). Chronic wound A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do. Wounds that do not heal within three months are often considered chronic. Chronic wounds seem to be detained in one or more of the phases of wound healing. Chronic wounds often

Vitiligo Unveiled

Characterised by white patches and spots appearing anywhere on the body, vitiligo is a frequently misunderstood, misjudged and complex s kin condition. For years, people with vitiligo have been stigmatised and bulli ed, largely due to society’s ignorance. Fortunately, this mindset has seen a positive shift of late, as recent media exposure on vitiligo has brought about a better general understanding and awareness. The poem Pied Beauty by Gerard Manley Hopkins celebrates all things that are dappled, stippled and freckled. He marvels at the distinct contrasts and patterns in nature, finding beauty in all that is unconventional. Yet the skin condition known as vitiligo – a loss of pigment in areas of the skin, resulting in the piebald effect the poet so admired – is more often than not misjudged and misunderstood. In its most dominant form, it is (ironically) perfectly symmetrical, appearing equally on both sides of the body. A perfect imperfection, one might say… The changing face of vitiligo Once stigmatised and deemed unslightly, the mindset and visibility of this skin condition has seen positive changes over recent years. This is due, in part, to remarkable women such as Canadian fashion model Winnie Harlow, American CoverGirl cosmetics ambassador and model Amy Deanna, and of course our very own Boitumelo Rametsi – founder of Spotted Beauty and vitiligo spokesperson. They have all inspired those with vitiligo by accepting their unique beauty and raising awareness. Moreover, they urge people to do away with the stereotypical ideals of beauty. In fact, Mattel has recently launched four new Barbie dolls – including one with vitiligo – in an attempt to be more inclusive and encourage body positivity. Be that as it may, vitiligo still causes deep distress for some, as well as provoking a risk of trauma and loss of confidence. A famous case in point is the late celebrity King of Pop, Michael Jackson, who claimed to suffer from vitiligo (he ‘came out’ on Oprah’s talk show in 1993), and went to extreme lengths to hide it. Unfortunately, he changed his appearance so drastically in the process, it ended up exposing him to serious negative attention. According to American dermatologist John E Harris, MD, Phd, it was unlikely that vitiligo alone could have caused such a radical transformation from African American to very pale skin. Indeed, his autopsy report revealed that he used a form of hydroquinone to lighten his skin. Whatever the case, in order to better understand this condition and gain some insight on treatment options, we spoke to: Dr Judey Pretorius Biomedical scientist Dr Pholile Mpofu Dermatologist Dr Debbie Norval GP with special interest in aesthetics What is vitiligo? Dr Pretorius “Vitiligo is a condition that causes patchy loss of skin pigmentation, and is considered progressive. Generalised vitiligo is deemed to be the most prevalent form and can be characterised as large areas of depigmentation occurring all over the body (it is not confined to a specific area or section). Segmental vitiligo, on the other hand, is considered less common (occurring in approximately 10% of affected individuals). It is characterised as smaller areas of depigmentation, appearing on one side of the body, in a limited area.” Dr Mpofu “In my practice, generalised vitiligo is common. Segmental vitiligo does occur, yet it’s quite unusual, appearing only in one area – i.e. Blaschko’s lines. This tends to be stable and more resistant to treatment. Common among my patients is vitiligo in areas of trauma – e.g. rubbing and scratching around the eyes, lips, elbows, neck, knees.” How does it usually develop and what causes it? Dr Pretorius “While any part of the body may be affected by vitiligo, depigmentation usually first develops on sunexposed areas of the skin, such as the hands, feet, arms, face and lips. Most experts believe that it is an autoimmune condition, in which the body’s immune system mistakenly attacks and destroys certain cells. Vitiligo is also sometimes associated with other medical conditions, such as thyroid dysfunction.” Dr Mpofu “Autoimmunity is the main cause of vitiligo. This is due to the melanocytes being affected, which ultimately leads skin to lose pigmentation.” In your practice, what treatment is the gold the standard for vitiligo? Dr Pretorius “We have developed a treatment protocol that uses melanocyte growth factors with microneedling techniques to stimulate repigmentation.” Dr Mpofu “The most successful type of treatment in my practice: avoidance of trauma (rubbing, scratching) calcineurin inhibitors topical steroids microneedling excimer light in rapidly spreading diseases, a course of systemic immune suppressors are used. Very effective is a combination of topical treatment and excimer light.” While hydroquinine is controversial in SA, it can be prescribed (below 2% strength) – is this a recommended topical treatment? Dr Pretorius “It can be used in persons affected by widespread treatment-resistant vitiligo to bring about a smoother, more uniform appearance. However, the active ingredient used can be limited in certain cases due to side-effects experienced by the individual. Hydroquinone is a very unstable molecule, and can basically only be prepared as a compounded item (and not a commercial product), which means that there isn’t much clinical data on its biological effects on the skin.” Dr Mpofu Certain drugs can also affect the pigmentation of the skin, as in the case of Bev Segal, Johannesburg wife, mother and volunteer for an NGO for underprivileged children, Magical Moments. Diagnosed with ocular melanoma in 2010, Bev underwent various treatments that included radiation, chemotherapy and five surgeries – as the cancer had metastasised to the liver. After an enucleation (removal of the right eye) and a course of metastatic melanoma treatments*, she was finally in remission. When the cancer returned two and a half years ago, it presented in the liver and bones. It was at this point that an immunotherapy drug* was prescribed. Bev explains further: “The medicine* I received was Biologic – a targeted therapy that works exclusively on one’s immune system, thereby limiting the side effects on healthy cells (unlike chemotherapy that targets all rapidly dividing cells).

sliced up fruits in a heart shaped plate

HIGH on skin

Health Ingredients Generation Homeostasis Health The skin is the most seen and public organ but yet, the least understood organ. The skin never lies; as sensory, nerves, temperature measurement, blood flow, perspiration and pore dilation activities are assessed during lie detection tests. Additionally, infrared cameras are used by security at airports to detect a fever amongst a crowd. We have to understand who we are and what our cells are made of as we recognise ourselves by our skin. A magnificent array of chemical reactions takes place on a molecular and cellular level within the skin. Human skin is a complex living material but in biomechanical tests it reveals its homogeneous nature. Our environment can directly influence who we are. The skin reacts immediately and directly to the outside environment. Human skin can be stretched to several times its original size and still maintain its original phenotypic properties. Such impressive expansion is possible because the skin is a highly specialised mechanical structure, responding through a network of interconnected cascades of chemical reactions, with the participation of extracellular, cytoplasmic and nuclear membranes. Healthy skin is the level of functional and metabolic efficiency of a living organism. In human skin it is the ability to adapt and self-manage when facing physical, mental, psychological and social changes. Our skin’s health is a complex biological process influenced by a combination of intrinsic (genetics, cellular metabolism, hormone and metabolic processes) and extrinsic (chronic light exposure, pollution, ionising radiation, chemicals, toxins) factors. Ingredients Particular compounds and molecules need to be applied to the demanding skin in order to assist and supplement a homeostatic balance at all times even when the skin is exposed to social and environmental stressors. A product with measurable quality, safety and efficacy standards should be considered. Stereo chemical properties of the active and inactive ingredients applied to the skin is explicitly important, i.e. the chemical characteristics of a compound should be understood in order to ensure that a therapeutic and biological benefit is obtained on a cellular level. There are two main groups of agents that can be used as skin health topical components, the antioxidants and the cell regulators. The antioxidants, such as vitamins, polyphenols and flavonoids, reduce collagen degradation by reducing the concentration of free radicals in the tissues. The cell regulators, such as retinols, peptides and growth factors (GF), have direct effects on collagen metabolism and influence collagen production. Vitamins C, B3, and E are the most important antioxidants because of their ability to penetrate the skin through their small molecular weight. The water-soluble, heat-labile local L-ascorbic acid (vitamin C) in concentrations between 5 and 15% was proven to have a skin anti-aging effect by inducing the production of Collagen-I, and Collagen-III, as well as enzymes important for the production of collagen, and inhibitors of matrixmetalloproteinase (MMP) I (collagenase I). Vitamin E (α-tocopherol) used as a component of skin products has antiinflammatory and antiproliferative effects in concentrations between 2 and 20%. It acts by smoothing the skin and increasing the ability of the stratum corneum to maintain its humidity, to accelerate the epithelialisation, and contribute to photoprotection of the skin. Vitamin A (retinol) are also a group of agents with antioxidant effects. Retinol is, at the moment, the substance that is most often used as an anti-aging compound. It has been shown that retinol has positive effects not only on extrinsic but also on intrinsic skin health and has a strong positive effect on collagen metabolism. It has been shown to be able to reduce the signs of UV-induced early skin health, such as wrinkles, loss of skin elasticity and pigmentation. Polypeptides or oligopeptides are composed of amino acids and can imitate a peptide sequence of molecules such as collagen or elastin. Through topical application, polypeptides have the ability to stimulate collagen synthesis and activate dermal metabolism. Chemical peels are methods to cause a chemical exfoliation of defined skin layers to induce an even and tight skin as a result of the regeneration and repair mechanisms after the inflammation of the epidermis and dermis. Chemical peels are classified into three categories. Superficial peels [α-β-, lipo-hydroxy acids (HA), trichloroacetic acid (TCA) 10–30%] exfoliate epidermal layers without going beyond the basal layer; medium-depth peels (TCA above 30 to 50%) reach the upper reticular dermis; deep peels (TCA > 50%, phenol) penetrate the lower reticular dermis. The depth of peeling depends not on the substance used only, but on its concentration, pH of the solution and time of application. A number of skin modifications have been reported after several weeks: epidermal architecture returns to normal, melanocytes are present and distributed uniformly, basal cells contain small melanin grains distributed homogeneously, the thickness of the basal membrane is homogeneous, in the dermis, a new sub epidermal band of collagen appears, elastic fibers form a new network, often parallel to those of collagen. If superficial peelings target the corneosomes, cause desquamation, increase epidermal activity of enzymes, lead to epidermolysis and exfoliation, medium-depth peels cause coagulation of membrane proteins, destroy living cells of the epidermis and, depending on the concentration, the dermis. Deep peels coagulate proteins and produce complete epidermolysis, restructure of the basal layer and restoration of the dermal architecture. Generation Healthy and functioning skin barrier is important protector against dehydration, penetration of various microorganisms, allergens, irritants, reactive oxygen species and radiation. The skin barrier may be specifically adjusted to allow penetration. For this reason, daily skin care may increase skin regeneration, elasticity, smoothness, and thus temporarily change the skin condition. Mechanical activation of the skin initiates the signalling pathways, which in turn activate the transcription of factors stimulating gene expression, that causes a cascade of events which results in an increased mitotic activity and collagen synthesis. Changes in the skin tissue occurring during dermatological treatments initiate these paths that also increase the mitotic activity and the synthesis of collagen. However, if external stimuli such as mechanical stress reach sufficiently large values, they may cause irreversible deformation and damage to the skin, resulting in

Balanced Skin Biochemistry

The skin is the most visible organ, yet the least understood, with a magnificent array of chemical reactions taking place within it on a molecular and cellular level. Addressing skin biochemistry is key in combatting the effects of ageing. The skin never lies – literally – as sensory, nerve, temperature, blood flow, perspiration and pore dilation activities are assessed during lie detection tests. With this in mind, it’s apparent that we have to understand who we are and what our cells are made of, as we recognise ourselves by our skin. Human skin is a complex living material but reveals its homogeneous nature in biomechanical tests. Our environment can directly influence who we are and the skin reacts immediately and directly to the outside environment. The skin and subcutaneous tissue provide a protective covering of the body, capable of stretching and contracting. Skin thickness measurements are used to evaluate skin characteristics, and biomechanical skin parameters change with time. The process of ageing is the reason why the skin becomes thinner, stiffer, less tense and less flexible. Flexibility and reactivity Human skin can be stretched to several times its original size and still maintain its original phenotypic properties. Such impressive expansion is possible because the skin is a highly specialised mechanical structure, responding through a network of interconnected cascades of chemical reactions, with the participation of extracellular, cytoplasmic and nuclear membranes. When the skin is stretched above its physiological limit, a series of reactions activating ion channels, integrins, growth factor receptors and G-receptors conjugated with protein reactions takes place. These reactions aim to restore the homeostatic balance. The skin also comprises a network of immune cells and antimicrobial peptides that increase in response to microbial invasion. In order to achieve cellular longevity and amplified cellular energy, cell metabolic activity should function at an optimal state. The main source of cellular energy is the mitochondrion. A skin cell, such as a fibroblast or a keratinocyte, can typically contain anything between 100 to 2 000 mitochondria that produce the molecule adenosine triphosphate, which provides energy for a cell during mitotic activity and enhances cell turnover time. Mechanical activation of the skin initiates the signalling pathways, which in turn activate the transcription of factors stimulating gene expression, causing a cascade of events that result in increased mitotic activity and collagen synthesis. Changes in the skin tissue that occur during dermatological and surgical treatments initiate these paths, also increasing mitotic activity and the synthesis of collagen. However, if external stimuli such as mechanical stress reach sufficiently large values, they may cause irreversible deformation and damage to the skin. Incorrect pH imbalances ionic activity to the skin, which may inherently degrade or destabilise proteins. The right biochemical and dermatological interventions Biomechanical tests of the human skin help to quantify the effectiveness of dermatological products, detect skin diseases, and help to schedule and plan surgical and dermatological interventions and treatments. One person’s skin metabolic profile differs from another according to social and environmental pressures, and the biomechanical parameters of the skin alter over the course of one’s life. During the ageing process, the skin becomes thinner, stiffer, less tense and less flexible, and protective functions against mechanical injuries decrease. Due to the complex importance of cell kinetics, the active ingredients of topical products should therefore comprise specific pharmacokinetic properties that assist against mechanical injury. Particular compounds and molecules need to be applied to the demanding skin in order to assist and supplement a homeostatic balance at all times, even when the skin is exposed to social and environmental stressors. A product with measurable quality, safety and efficacy standards should be considered. The overall architectural building blocks of the skin – such as macromolecule kinetic pathways, cell permeability and cell polarity – should be assessed carefully when products are applied topically. Applying products with stereo chemical properties of the active and inactive ingredients to the skin is explicitly important. This means that the chemical characteristics of a compound, for instance vitamin C (ascorbic acid), should be thoroughly understood in order to ensure that a therapeutic and biological benefit is obtained on a cellular level. Molecular weight is important, as the compound applied topically should be dramatically smaller than the target skin cell macromolecule it needs to bind with, in order to stimulate a biological response. There are various derivatives and compound by-products available on the market that ultimately only apply more metabolic strain on a skin cell. Products should stimulate ample membrane ion channelling in order to activate and increase transient ATP production and not arouse an inflammatory response. It has been found that mitochondria from skin cells cannot be isolated thoroughly with solutions at neutral or alkaline pH levels, which highlights the importance of an acidic milieu in the skin. Incorrect pH provides an imbalanced ionic activity to the skin, which may inherently degrade or destabilise proteins. A product with the correct pH should thus contribute or absorb hydrogen atoms to or from the skin, rather than reacting with extracellular proteins. Ionic activity enables optimal transdermal absorption and therapeutic protein binding both inside and outside the cell, indicating the important role pH plays in skin chemistry. The “conductivity” and “polarity” of product ingredients promotes product absorption by means of ion channelling, hydrophobic and hydrophilic properties, isotonic, hypertonic and hypotonic activity. The aforementioned are all considerations for an ageing or injured skin that requires specific topical exposure or dermatological intervention to accommodate the biochemical changes of skin over time.

Doctor applying honey-based wound care to a patient's upper arm

Use of Honey-Based Dressings to Increase Patient Compliance: Case Reports

Introduction A considerable amount of research has been performed to identify and continuously develop novel therapeutic approaches and technologies for the management of acute and chronic wounds.1 The development of new approaches however, requires the understanding of the physiological trajectory of normal wound healing, described as the phases of haemostasis, inflammation, proliferation and remodelling. These four highly programmed, integrated and overlapping phases, occur in a specific time frame and sequence, in order for successful wound healing to occur.2-3 Numerous factors can cause a disruption or affect one or more of these stages,1 resulting in a non-healing chronic wound or delayed wound healing.3 The latter has, through history, been a global concern due to the distress and discomfort it causes to the patient.4 Subsequent to the rate of wound healing and especially in aesthetically sensitive locations, the degree of scarring post wound healing becomes an important factor to consider due to the life-long psychological and/or functional implications it may have on the patient.5 Although novel wound care techniques, such as negative pressure wound therapy (NPWT), have been developed and implemented with great success in the past two decades, patient-related factors play an important role in considering other therapies. A study performed in 2014 highlighted patients’ experience with the use of NPWT, particularly the effect this therapy had on the patients’ personal environment (physical, mental, social and spiritual aspects).4 One important factor to consider is the possibility of infection, as a wound causes a break in the integrity of the skin and therefore increases the susceptibility to microorganism infiltrations and subsequent infection. By preventing or treating the infection effectively, it can significantly improve wound healing.6 Accomplishing this task has become a difficult endeavour in the modern age, due to the increased resistance of microorganisms towards antibiotics as a result of the inappropriate use of these products. Hence, exploring alternative therapies becomes increasingly crucial, and although many exist, implementation thereof may be challenging.7 By considering the aforementioned factors, the author’s approach in the case was utilising a product (Wound Occlusive®) containing an age-old remedy, honey. The utilisation of honey-based topical products has re-emerged in the past few decades, with more evidence and data supporting beneficial claims associated with the use of honey-based products on wounds, such as the pH lowering effect on the wound; the ability to penetrate through biofilms; the debriding capacity; and the antibacterial and anti-inflammatory activity.8 Clinical Cases 1. Patient A: A 66 years old male presented with a post-skin flap surgical wound. Injury to the patient’s knee resulted from a car accident earlier in the year, where a skin flap was eventually performed. The wound has been treated using a NPWT dressing. The main complaint of the patient was that his quality of life had been affected by the current treatment as he was no longer able to function in his current job, and implied that the use of the dressing necessitated him to visit a professional nurse for every dressing change, while he was not noticing real improvements. The patient had diabetes Type 1 (well-controlled), was a non-smoker and appeared generally healthy. The wound (42 mm [length] x 21 mm [width]) was located on the lateral side of the left knee, and during the first observation it could be stated that there were clear signs of inflammation and oedema in the tissue surrounding the knee and wound. The patient was admitted to hospital just prior to the appointment due to severe pain in the wound. During admission the NPWT dressing was replaced and the decision was made during the initial appointment after admittance to hospital that removal of the vacuum dressing would be postponed for another five days, which served as an observation period. The treatment protocol adopted consisted of cleaning the wound with saline followed by an application of a thick paste of Wound Occlusive®. An absorbent dressing was applied as a secondary dressing due to the amount of exudate on the wound. Initially the wound dressing was changed every 48 hours, and after two sessions of 48 hours, the dressing change was moved to a 72 hours regimen. Figure 1 shows that the size of the wound decreased significantly over the period of one month. In addition, it is observed that inflammation and oedema surrounding the wound had also decreased after one week of treatment; this observation was also supported by patient’s feedback. 2. Patient B: A 13-year-old male presented with significant soft tissue injuries in the face post suture. The injury was the result of a hyena bite. The injury extended from the frontal region through the right orbital, right infraorbital, right upper cheek, right nasolabial and the contralateral perioral area. 3. Patient C: A 31-year-old healthy male presented with a brown recluse spider bite, otherwise known as the violin spider. The bite took place approximately eight days before surgical debridement of the wound was performed. The wound measured 75 mm (length) x 20 mm (width) x 5 mm (depth) located on the left antebrachium (forearm). After surgical debridement the wound was left open, whereafter the treatment protocol adopted consisted of cleaning the wound with saline followed by an application of a thick paste of Wound Occlusive®; an absorbent dressing was applied initially to accommodate the amount of exudate on the wound, although this was changed after 48 hours to a paraffin gauze dressing followed by the application of a crepe bandage. From Figure 3a to Figure 3c it can be noted that both the length, width and depth of the wound decreased within the period of one week. Additionally, it should be mentioned that the amount of exudate present on the wound bed was markedly lower and no signs of infection could be noted. Discussion Wounds can significantly affect a patient’s quality of life in numerous ways due to pain, odour, decreased mobility, social isolation, psychological problems such as depression and anxiety, and the inability of the patient to perform daily duties and activities.9 These factors place emphasis on the importance of treating

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