Trach/mrsa/d50

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Recently at my critical care consortium a nurse was saying that at her facility, they often use a trach dressing dampened with D50 to facilitate and speed up healing of the trach siteof the pt with MRSA. I know that sugar and honey have been proven to be effective wound granulators, but has anyone heard about trachs/MRSA/D50? I have googled, and not found much in the way of literature-any thoughts? I do know from a microbial standpoint D50 is too hypertonic to grow anything in/on the wound.....

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Specializes in Critical Care, Emergency.

i can't see where d50 will not grow anything on/in the wound area.. albeit hypertonic and full of dextrose (25% concentration), it provides a great source for bacteria.. perhaps honey has different properties for fighting bugs, since babies can't even handle it.. perhaps i'm way off, but it's my 2 cents - -

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Specializes in ICU, Education.

no literature seen here either. Seems like a good dinner for bacteria to me. I would truly be interested if someone had some data to back that up.

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Hey T-Fish

The only way that I can see that sponging an open wound with D50 would be helpful is if you figure the 'irritation' of the strong glucose would close off the capillaries of the open wound. OK? You got any alternative explanation?

The contrary argument is that it feeds the bacteria that naturally inhabit the open wound.

I vote that the contrary argument is stronger. Unless some contributer with special wound healing certification comes along and backs up the D50, I'd be very very skeptical. (And probably even if they DID.)

Who wants to feed pathogens?

Papaw John

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i can't see where d50 will not grow anything on/in the wound area.. albeit hypertonic and full of dextrose (25% concentration), it provides a great source for bacteria.. perhaps honey has different properties for fighting bugs, since babies can't even handle it.. perhaps i'm way off, but it's my 2 cents - -

Babies can't have honey because of the botulism spores. They have immature guts and if they ingest the spores are at high risk for getting botulism. This is for raw honey. I'm not sure about commerically processed honey.

Have never heard of the D50 bit for trach dressings. Seems like it would be an awesome food source for bacteria.

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As much as i love innovation I have to agree with the previous posters on this one.

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Specializes in ER.

High sugar concentration is actually a bacterial inhibitor...sugar and salt are used as preservatives because they bind up water and make it unavailable to bacteria, inhibiting growth.

How that relates to putting D50 on a trach site, I have no clue. Almost sounds like someone taking the idea I stated above and trying to stretch it way to far....but who knows. Now I am curious and want to go look this up!

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Specializes in critical care, med/surg.

i'VE ACTUALLY SEEN RESEARCH FROM jAPAN ON HONEY AND lUGI'S SOLUTION BEING USED TO CONTROL INFECTION IN THE POOR PARTS OF THIRD WORLD COUNTRIES BUT HAVE YET TO HEAR ABOUT D50. Sry for shouting

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High sugar concentration is actually a bacterial inhibitor...sugar and salt are used as preservatives because they bind up water and make it unavailable to bacteria, inhibiting growth.

That's true. But consider that a living layer of cells (as opposed to a dead ham shank) is engaged in moving fluid in and out (simple diffusion or active transport) in order to maintain homeostasis. So the interface between the cell membrane and the D50 (even though we're only talking a few microns here) will not be 25% glucose. Almost necessarily it will be less, since osmotic forces will favor movement of water from the cells and into the interface. I think the other responders are correct. "D50" will provide a nice glucose and protien rich media for bacterial growth.

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Specializes in ER.
High sugar concentration is actually a bacterial inhibitor...sugar and salt are used as preservatives because they bind up water and make it unavailable to bacteria, inhibiting growth.

That's true. But consider that a living layer of cells (as opposed to a dead ham shank) is engaged in moving fluid in and out (simple diffusion or active transport) in order to maintain homeostasis. So the interface between the cell membrane and the D50 (even though we're only talking a few microns here) will not be 25% glucose. Almost necessarily it will be less, since osmotic forces will favor movement of water from the cells and into the interface. I think the other responders are correct. "D50" will provide a nice glucose and protien rich media for bacterial growth.

Notice that I added that I had no clue how that concept could be stretched to wound care, just that that is probably be the rationale that may be being used.:)

I made considerable effort to look up information on this topic, and found zip (I did find lots on why sugar paste has been found an effective treatment- that was interesting- sugar paste works on a wound just as with a preservative, draws water; pulls fluid from wound)....so I am thinking that it is not an evidenced based practice, in the least.

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