BCMH Sheet in Chronic Lower Extremity Wounds
Dr. Tony Alleman, MD, MPH, remarks on the wound healing seen in a recent paper assessing a bioengineered collagen with Manuka honey and hydroxyapatite sheet for chronic wounds (BCMH).
Transcript
I am Dr. Tony Alleman and I work at Regional One Health in Memphis where we have a wound care and hyperbaric center. We see anywhere from 20 to 50 patients a day, and a lot of them have chronic wounds. Some of them have conditions that we will treat with hyperbaric oxygen therapy. I've been in wound care for probably about 15 years. My training is from LSU in New Orleans, and I'm board certified in undersea and hyperbaric medicine.
We've used both of these products separately in the past, and this particular product uses them together as a single product. For healing, collagen is very important. It is the basic building blocks, if you will, of getting a wound to heal. So the fact that collagen is available in a substrate, let's say, for wound healing is very important. The Manuka honey probably adds an antimicrobial aspect to this so that your wounds don't become infected.
Well, if we had a bigger size of this product, I would love to try it on some venous stasis ulcers, but most of the venous stasis ulcers that we see are way larger than the product sizes that we had available. I'm not sure if there's a plan on producing a larger size of this product that could be used on a venous ulcer.
In choosing, I guess a product, I wish we could say that there's a huge amount of science, but sometimes it's trial and error. And we use these skin substitutes, like our Manuka honey collagen product, we use the skin substitutes when all the rest of our products have failed. Typically, the skin substitutes are very expensive as compared to, let's say, routine kind of products. And so we save them for last. And then a lot of times the insurance companies have to approve their use before we put them on there. So outcomes, I mean, in our experience we had some of the patients responded very well. Where I remember one patient we had, he'd been having wounds for months and we had tried a variety of products. And we put this particular collagen Manuka honey product on, and within a few weeks it was closed. It was incredible, his response. Now, we had some failures also, so there's no one perfect product and it's going to be matching the product to the patient to determine what's best for them.
I think that probably is from the literature, I think our rate of healing is higher than what's quoted here. Part of that is we have a burn center that's associated with our facility, so we see a lot of burns. Most burns will heal. Now, having said that, we did have one lady who had a burn with a skin graft, and she was non-compliant and had diabetes and a bunch of complicating comorbidities, but we eventually got her healed, but it took 2 years. But most burns will heal a lot faster than that. So I would say overall our wound healing is better.
Yes, we're always looking for other options, let's say. Now our facility won't let us stock unlimited number of products, so we have to pick and choose which ones we use. Some of them are very similar, and some of them are very, very different. This one is different in the fact that it has the Manuka honey combined with the collagen. The other skin subs, some of them are placental-based or amniotic-based products, and those are way different than the one that we used here.
Well, I like to see different products. I mean, one of the products that we tried recently was a fish skin product. Unfortunately, we didn't have the success that I would've hoped for. In fact, I don't remember any one patient that we healed with the fish skin. So we're always looking for new things that might help us with some of these chronic wounds that we have, it seems like we've tried everything and they just are stubborn wounds.
