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The Pharmaceutical Journal Vol 263 No 7075 p948
December 11, 1999 Letters

Wound care

Sugar paste

From Mr J. D. Topham, MRPharmS

SIR,—I was pleased to see in David Morgan's article on wound care products (PJ, November 20, p820) that the deodorising properties of sugar pastes are mentioned. He also states that sugar may exert its antibacterial effect by competing for water present in the cells of bacteria. This is clearly shown by Loncin and Merson1 and Chirife et al.2
Both sugar and honey3 are widely used to treat wounds. They need the addition of an adhesive hydrogel (gum)4 to enable them to absorb exudate and reduce or eliminate scarring. I found that daily or alternate day dressing changes did not produce the trauma to patients associated with frequent dressing changes experienced by Seal and Middleton.5 I also found that when excessive quantities of exudate were produced, these were held in the thin ventilated polythene covering6 with no apparent inhibition of the healing process.
A disadvantage of the paste used at Northwick Park hospital by Middleton and Seal7 is that, in some wounds, hypergranulation (excessive flesh) occurs. I discovered that the presence of povidone prevented this.8

John Topham
Southsea, Hampshire

References
1. Loncin M, Merson RL. Food engineering principles and selected applications. London: Academic Press, 1979:200-1.
2. Chirife G et al. In vitro study of bacterial growth inhibition in concentrated sugar solutions. Atimicrob Agents Chemother 1983; 23:766-73.
3. Cooper RA, Molan. PC Honey in wound care. J Wound Care 1993;8:340.
4. Topham J. What's new in wound treatment? Not a lot! J Tissue Viability 1994;4:86-9.
5. Seal DV, Middleton K. Healing of cavity wounds with sugar. Lancet 1999; 338:571-2.
6. Topham J. Sugar paste and povidone iodine in the treatment of wounds. J Wound Care 1996;5:364-5.
7. Middleton KR, Seal D. Sugar as an aid to wound healing. Pharm J 1995;235: 757-8.
8. Topham JD. In a Zanzibar factory. Pharm J 1992;249: 191-2.