Centre for Health and Social Care Improvement

Sugar Research by Moses Murandu

A Pilot study: Using granulated sugar for managing wounds/ulcers

Senior Lecturer Moses Murandu grew up in Zimbabwe and his father used granulated sugar to heal wounds and reduce pain when he was a child. But when he moved to the UK, he realised that sugar was not used for this purpose here. Find out more about this award winning research below.

Background:

Although widely used in Africa there is limited evidence to support the use of granulated sugar to treat wounds. But there is an increasing evidence of the benefit of honey in wound care. Granulated sugar and honey works in a similar way because both have higher sucrose content that interferes with water activity (De Foe 2004, Mpande et al 2005, Chirife et al 1980). This has potential benefit in encouraging wound debridement. 

Aim:

To determine whether granulated sugar is effective when used on managing exudating wounds/ulcers and  develop a protocol for use in a Randomised Controlled Trial.

Inclusion and Exclusion Criteria:

Inclusion Criteria  Exclusion Criteria
Patients who can independently and willingly consent
Ankle Brachial Pressure Index (ABPI) of less than 0.6
Exudating wounds
Presence of necrotic escar
Diabetic & Non Diabetic patients with all of the above
All pregnant women

Method:

Method : Granulated cane sugar poured into open wound.

Results: 

Leg Ulcers : Week 1 to Week 3

Post Fasciotomy Infection - Day 1 to Day 9

Diabetic Foot Ulcer - Day 1 - Day 14

Discussion:

Clinical studies: Evidence collected, during the course of the pilot study found that most patients presenting with chronic wounds faced a number of challenges which included peripheral vascular disease, poor nutritional status and limited understanding of their chronic illnesses.

Pain: Pain and comfort can be a deciding factor when choosing a reliable, efficient dressing for any patient. Some patients suffered from limited mobility due to pain. It was observed that in the case of four patients, their use of this medication reduced and their pain was managed well using simple analgesics such as Paracetamol and Codeine.

Diabetic Patients: Blood sugar levels for diabetic patients remained stable for all seven patients.

Odour: We had not anticipated the immediate and dramatic decrease in wound odour which enabled us to move patients from isolation to the open ward within 24 hours of commencing treatment, or the marked reduction in analgesic requirements, particularly in venous ulcer patients who had previously refused bed rest and elevation on the grounds that this position was intolerably painful.

Wound Debridement: Most patients accepted into the study had wounds that were heavily exudating with sloughy necrotic tissue on entering study, after 14 days of sugar treatment, there was evidence of debridement.

 

Conclusion:

It is important to note that skin breakdown is a problem to health care around the globe and costs the National Health Service (NHS) around £2.3-£3.1 billion per year (Posnett and Franks 2007).

Despite years of research there is still a search for optimal methods to enhance treatments. Methods range from complex and expensive pharmaceutical treatments to the simple such as sugar and honey. Simple and non-expensive treatments would save costs to the NHS but would also make treatment options in poorer parts of the world.

We were impressed by the adaptability of the sugar dressing technique to all varieties of wound, whether superficial or deep, dry or exudative and to the temporal flexibility with which it could be deployed, from twice-daily to once-weekly.

Sugar inhibits bacterial growth so it is plausible that sugar can reduce or prevent infection of wounds from a microbiological point of view.

Future directions/ongoing work:

A large randomised controlled trial is at the final planning stage and it is anticipated that it will commence in the autumn of 2010.

 

References:

Chirife J, Herszage L, Joseph A, Kohn ES (1983). In vitro study of bacterial growth inhibition in concentrated sugar solutions:microbiological basis for the use of sugar in treating infected wounds. Antimicrob Agents Chemother; 23: 766–773

De Feo, M., De Santo, L. S., Romano, G., Renzulli, A., Della Corte, A., Utili, R., Cotrufo, M. (2003). Treatment of recurrent staphylococcal mediastinitis: still a controversial issue. Ann. Thorac. Surg. 75: 538-542

Mphande, A.N.G. Kilowe, C., Phalira, S., Jones, H.W. and Harrison, W.J. (2005). Effects of honey and sugar dressings on the wound healing. The International Journal of Lower Extremity Wounds. 5, 1, 40-54

Posnett, J and Franks, P (2007) The cost of skin breakdown and ulceration in the UK in Smith and Nephew Foundation (2007)  Skin Breakdown - the silent epidemic. snfoundation, uk

Price. P (1998) Health-related quality of life and the patient’s perspective. Journal of Wound Care 7(7) 365-366.

Winston Churchill Memorial Trust fellowship blog

Public lectures

Research themes button