Can Dressing be used in diabetic patients? Will honey influence the blood sugar?
敷料可用於糖尿病患者嗎?蜂蜜會影響血糖嗎?

Dressing does not influence the insulin levels in diabetic patients. For many years the Diabetic Centre in The Netherlands has been using honey in wound care achieving excellent results without experiencing any negative effects. This may be explained by the fact that the quantity of sugar absorbed in these wounds is extremely low. There will be no detectable effects on blood sugar levels. Frequent monitoring of these levels in diabetic patients has never shown this. Should there be any reason to suspect a change in blood sugar levels, whichever the cause, we advise close monitoring. (Diabetic) Children with large surface areas afficted should always be monitored closely.

敷料不會影響糖尿病患者的胰島素水準。多年來,荷蘭的糖尿病中心一直使用蜂蜜治療傷口,取得了優異的效果,沒有出現任何負面影響。這可以通過以下事實來解釋:這些傷口中吸收的糖量極低。對血糖水準沒有可察覺的影響。糖尿病患者對這些水準的頻繁監測從未顯示過這一點。如果有任何理由懷疑血糖水準的變化,無論是什麼原因,我們建議密切監測。(糖尿病)應始終密切監測受糖尿病之苦的兒童。

What is Mel-Max?
什麼是Mel-Max?

MelMax is a sterile wound dressing impregnated with a mixture of metal‐ion formulation ointment and buckwheat honey.

MelMax 是一種無菌傷口敷料,浸漬了金屬和電劑的混合物,以及小麥蜂蜜。

What is the ratio metal‐ion formulation versus Buckwheat honey
金屬和電子配方與巴克麥蜂蜜的比率是多少?

Metal‐ion formulation ‐ 25%
Buckwheat honey ‐ 75%
The results of in vivo tests showed the best performance for this 25:75 ratio.

金屬+電子配方=25%,小麥蜂蜜=75% ,體內測試結果表明,此 25:75 比率的最佳性能。

Why Buckwheat honey?
為什麼是巴克麥蜂蜜?

Dark buckwheat honey is a rich source of phenolic compounds.

黑麥蜂蜜是酚類化合物的豐富來源。

What are phenolics?
什麼是酚類?

Antioxidants (i.e. phenolics) are agents that can retard biologically destructive chemical reactions in foods and living organisms. These compounds are thought to protect humans from diseases.
Phenolics are general known to have antibacterial activity.
Phenolics have strong anti‐oxidant properties.

抗氧化劑(即酚類藥物)是能夠延緩食品和生物有機體中具有生物破壞力的化學反應的製劑。這些化合物被認為可以保護人類免受疾病的侵害。酚類一般已知具有抗菌活性。酚類具有很強的抗氧化劑特性。

In which sizes is MelMax available?
提供哪些尺寸?

5 x 6 cm (10 dressings per box)
8 x 10 cm (10 dressings per box)
8 x 20 cm (10 dressings per box)

What are the benefits of MelMax?
MelMax有哪些優勢?

.Normalisation of the wound micro‐environment
.Regulation of bacterial contamination
.Inhibition of ROS production
.Scavenging of oxygen radicals
.Normalisation of MMP balance

.傷口微與環境的正常化
.細菌污染的調節
.ROS生產的抑制
.氧基的清除
.MMP平衡的正常化

How is the active metal‐ion formulation delivered to the wound bed?
活性金屬離子製劑如何輸送到傷口床?

The polyethylene‐based ointment is impregnated into an acetate carrier. It melts into the wound allowing diffusion of the metal‐ion formulation into the wound bed.
聚乙烯+基藥膏浸漬到醋酸載體中。它融化到傷口處,使金屬離子的配方擴散到傷口床上。

4% Purified water is added to the ointment and the polyethylene glycol to hold moisture in the dressing.
4% 純淨水加入膏和聚乙烯乙二醇,以保持敷料中的水分。

The metal ions are free floating in the ointment and attracted to what is negatively charged (ionic exchange).
金屬離子在藥膏中自由浮動,並被帶向負電荷(離子交換)。

The metal ions are carried in the ionic ointment travelling into the fibroblast. Rubidium, which is a larger ion, is the door opener to the cell followed by calcium, zinc and potassium.
金屬離子被攜帶在離子藥膏中,進入成纖維細胞。銣是一種較大的金屬離子,是細胞的門打開器,其次是鈣、鋅和鉀。

An optimal contact of the dressing with the wound bed is required.
是敷料與傷口床的最佳的接觸。

What does regulation of bacterial contamination mean?
細菌污染的調節意味著什麼?

Regulation means down‐regulation of the amount of bacteria. Our clinical investigations have shown that contaminated wounds treated with MelMax could heal properly without any sign of infection.
"MelMax keeps bacteria under control!"
調節意味著細菌數量的降低和調節。我們的臨床研究表明,使用MelMax治療的受污染傷口可以正常癒合,沒有任何感染跡象。

What is the carrier of the MelMax dressing and what are its benefits?
MelMax 敷料的載體是什麼,其優點是什麼?

The carrier is Acetate
Practical benefits of the acetate carrier over co^on gauze:
.Gradual delivery of the ointment to the wound bed
.Optimal drainage of exudate to secondary dressing
.Easy to apply
.Easy to remove
.No particles lee in the wound bed
.No irritation of the wound bed
(in contrast to co^on dressings)

載體是醋酸鹽
醋酸載體比紗布的實際優勢:
.將藥膏逐漸送到傷口床
.將滲出物的液體排到二次敷料上
.易於應用
.易於移除
.傷口床上不會有顆粒
.對傷口床無刺激
(與敷料的粘合床形成對比)

How many grams of the Ionogen Formulation and Buckwheat honey are in a MelMax dressing?
在MelMax敷料中有多少克的金屬離子配方和巴克麥蜂蜜?

8 x 10 cm: 4.8 gr.(克)
8 x 20 cm: 9.7 gr.(克)

Is MelMax blocking a proper drainage of exudates causing maceration?
MelMax 是否阻止了適當的滲出物排水,導致滲水導致浸漬?

Honey creates a moist environment by drawing exudate to the wound surface, creating a non‐ adherent interface between the dressing and wound bed. The osmotic withdrawal of fluid by honey does prevent maceration of periwound skin. (Clinical usage of honey as a wound dressing, Peter Molan, JWC vol 13, no 9, October 2004)

蜂蜜通過在傷口表面繪製滲出物,在敷料和傷口床之間創建一個非粘附介面,從而創造潮濕的環境。蜂蜜對液體的滲透性抽回確實能防止圍皮的浸漬。(臨床使用蜂蜜作為傷口敷料,彼得莫蘭,JWC第13卷,No 9,2004年10月)

Are there any side effects reported on the MelMax treatment?
(e.g. allergic reaction)
MelMax 治療是否有任何副作用報告?(例如過敏反應)

No side effects, like allergic reactions have been reported – status September 2011.
MelMax wound dressings should not be used on patients with known extreme sensitivity to Buckwheat honey, acetate or metal‐ion formulation.
Honey has an osmotic effect, which can cause a prickling pain sensation during approx. 15 minutes during the dressing has been applied.
None of the patients described dressing removal as painful – see question 11

沒有副作用,如過敏反應報告 - 狀態2011年9月
MelMax傷口敷料不應用於已知對巴克麥蜂蜜、醋酸或金屬+電子製劑極端敏感的患者。蜂蜜有滲透性,在大約15分鐘內引起刺痛感。敷料已應用。沒有一個患者將敷料描述為疼痛 - 參見問題 11

When to use MelMax?
何時使用?

MelMax® is intended for use with critically colonised and/or infected wounds, like:
• Acute wounds (surgical/trauma wounds)
• Chronic wounds (leg ulcers, decubitus and diabetic ulcers)
• Burns
• Wound bed preparation

MelMax® 用於嚴重植皮和/或受感染的傷口,例如:
* 急性傷口(外科/創傷創傷)
* 慢性傷口(腿部潰瘍、下肢潰瘍和糖尿病潰瘍)
* 燒傷
* 傷口床準備

How to use MelMax®?
如何使用?

• Carefully inspect the wound.
• Cleanse the wound according to instructions.
• Apply MelMax directly over the wound assuring an optimal contact with the wound bed.
• For moist or wet wounds apply a secondary absorbing dressing over the MelMax
• Secure with perforated adhesive tape.

• 仔細檢查傷口。
• 按照說明清潔傷口
• 將Mel-Max直接敷在傷口上 確保與傷口床的最佳接觸.
• 對於潮濕或溼的傷口,在Mel-Max上再覆蓋透氣敷料.可以吸收潮濕.
• 確實用透氣膠帶固定.

How to prepare the wound for MelMax® application?
如何準備Mel-Max®應用在傷口上?

Necrosis and debris needs always to be removed.
壞死和碎屑需要始終清除。

Can you cut the dressing?
能剪敷料嗎?

Yes, you can.
是的, 可以減裁需要的大小。

Can you overlay the surrounding skin?
能覆蓋周圍的皮膚嗎?

Yes, you can.
是的,可以。

What kind of secondary dressing do you need to apply on top of MelMax®?
在MelMax®上,你需要應用什麼樣的二級敷料?

Principelle Matrix can be used as secondary dressing for wet to dry wounds.
Traditional dressings, foams and/or alginate can be used as a secondary dressing.

主要可用作濕傷口至乾傷的二次敷料。傳統的敷料、泡沫和/或藻酸鹽可用作二次敷料。

How to fixate the dressing?
如何固定敷料?

You can fixate the dressing with skin friendly tape or with transparent film‐plaster.
您可以使用皮膚友好的膠帶或透明薄膜貼片固定敷料。

When to change the dressing?
何時更換敷料?

MelMax wound dressings should be changed preferably once per day (in case of wet infected wounds), however if the secondary dressing becomes soiled or leakage occurs it may be changed more frequently.
Most users change the dressing once every other day (in case of moist wounds) or even every third day (in case of dry wounds).
Our recommendation is to change daily at the start of the treatment. Based on the healing tendency the treatment can be extended from once per day to once every third day.

MelMax 傷口敷料最好每天更換一次(如果是濕感染的傷口),但如果二次敷料變髒或發生滲漏,則可能會更頻繁地更換。
大多數使用者每隔一天更換一次敷料(在潮濕傷口的情況下),甚至每三天更換一次(在幹傷的情況下)。
我們的建議是每天在治療開始時改變。根據癒合趨勢,治療可以從每天一次延長到每三天一次。

How to remove the dressing?
如何拆下敷料?

Remove the MelMax gently.
In case of some adhesiveness →Moisture the dressing prior to removal

輕輕取下Mel-Max。若是傷口在某種粘著的情況下•在拆卸前請使敷料保持濕潤.

Which features of Buckwheat honey contribute to the bacterial contamination?
巴克麥蜂蜜的哪些特性會導致細菌污染?

• The phenolic constituents
• Low pH of 3.5 – 4.5
• High free acid content of buckwheat honey present at 50 milli‐equivalents/kg
• The low moisture content of 16.8%

• 酚類成分
• 低 pH 值 3.5 ± 4.5
• 高游離酸含量的小麥蜂蜜,以 50 毫=當量/千克
• 低含水量 16.8%

Is Buckwheat honey safe for medical use?
巴克麥蜂蜜對醫療使用安全嗎?

To guarantee the product to be safe, Buckwheat honey was tested for contamination with heavy metals, pesticides, and antibiotics. The product is also gamma sterilised.

為了保證產品的安全,巴克麥蜂蜜被檢測為重金屬、殺蟲劑和抗生素的污染。該產品也經過伽瑪消毒滅菌。

What are Matrix Metalloproteinases (MMP's)?
什麼是基質蛋白酸(MMP)?

MMP's are a specific group of proteolytic enzymes. MMP's are playing an important role in remodelling extra‐cellular matrix. Furthermore, they help by clearing damaged tissue and build up new tissue.

MMP 是一組特定的蛋白解酶。MMP 在改造額外+蜂窩矩陣方面發揮著重要作用。此外,它們通過清除受損組織和建立新的組織來説明。

How are the MMP's influencing the healing process?
MMP 如何影響癒合過程?

MMP's are playing an important role in both epithelial degradation and regeneration. The MMP family of enzymes is capable of breaking down almost all of the components.

MMP在上皮退化和再生中都扮演著重要的角色。MMP酶系列能夠分解幾乎所有的成分。

What is the effect of imbalanced MMP production to the healing process?
不平衡的 MMP 生產對癒合過程有何影響?

Overproduction of MMP's is directly related to a non‐healing condition ‐ wounds will not, or only heal slowly.

MMP 的超產與非癒合條件直接相關-傷口不會癒合,或只是癒合緩慢。

Why use MelMax® in case of overproduction of MMP's (e.g. MMP2)?
為什麼在 MMP(例如 MMP2)生產過剩的情況下使用 MelMax®?

Recent research shows that the application of several metal ions combined with citric acid leads to be^er functioning of different cell systems related to wound healing. This will lead to an improvement of the MMP/TIMP balance.

最近的研究表明,幾種金屬離子與檸檬酸結合的應用,會導致與傷口癒合有關的不同細胞系統發揮作用。這將導致 MMP/TIMP 平衡的改善。

What are oxygen radicals?
什麼是有氧自由基?

Oxygen radicals play an important role in killing bacteria. When granulocytes are being activated their oxygen uptake rises and reactive oxygen species are formed.

有氧自由基在殺死細菌中起著重要的作用。當粒細胞被啟動時,它們的吸氧量上升,反應氧物種形成。

What are Reactive Oxygen Species (ROS)?
什麼是活性氧(ROS)?

Overproduction of oxygen radicals leads to overproduction of hydrogen peroxide inducing toxic levels of ROS production.

有氧自由基的過度生產導致過氧化氫的過度生產導致ROS生產的毒性水準。

What are the side effects of overproduction of oxygen radicals?
過度生產有氧自由基的副作用是什麼?

In chronic wounds there can be overproduction of oxygen radicals damaging vital tissue.
Overproduction of hydrogen peroxide leads to the formation of reactive oxygen species killing bacteria, but also causing damage to the granulocytes itself and to all other cell systems.

在慢性傷口中,有氧自由基可能過度生產,從而破壞重要組織。過氧化氫的過度生產導致活性氧物種的形成殺死細菌,但也對粒細胞本身和所有其他細胞系統造成損害。

Why use MelMax® in case of overproduction of oxygen radicals?
為什麼使用MelMax®在有氧自由基生產過剩的情況下?

Balancing production and removal is the key. Metal ions and phenolics each play their part in tissue regeneration.

平衡生產和清除是關鍵。金屬離子和酚類物質在組織再生中起著各自的作用。

What is Colonisation?
什麼是殖民化?

The presence of multiplying bacteria with no overt host reaction or clinical symptoms.
Microbial colonization of wounds has conflicting implications. Some studies have failed to associate specific micro‐organisms with delayed healing. Whereas Pseudomonas and Proteus have been recovered from enlarging and necrotic lesions.
Pseudomonas aeruginosa has been linked to larger wounds and Staphylococcus aureus an beta‐haemolytic streptococci associated with delayed healing.
Evidence that colonization contributes to delayed healing in chronic wounds has also been provided (Halbert et al. 1992).

存在無顯性宿主反應或臨床症狀的繁殖細菌。傷口的微生物殖民化具有相互矛盾的含義。一些研究未能將特定的微生物與延遲癒合聯繫起來。而偽多尼和普羅特烏斯已經從擴大和壞死病變中恢復過來。假多尼納斯阿魯吉諾薩與較大的傷口和金黃色葡萄球菌β-溶血性鏈球菌與延遲癒合相關。還提供了殖民化有助於慢性傷口癒合延遲的證據(Halbert等人,1992年)。

What is Critical colonisation?
什麼是關鍵殖民?

A conceptual term applied to the situation where host defences cannot maintain the balance of organisms in a wound.

一個概念術語,適用于宿主防禦無法維持傷口中生物體平衡的情況。

What is Contamination?
什麼是污染?

See colonisation
請參閱殖民化

What is an Infection?
什麼是感染?

The current accepted diagnostic criteria for wound infection are:
• Abscess
• Cellulitis
• Discharge
• Delayed healing
• Discolouration
• Friable, bleeding granulation tissue
• Unexpected pain/tenderness
• Pocketing/bridging at base of the wound
• Abnormal smell
• Wound breakdown

目前公認的傷口感染診斷標準是:
• 膿腫
• 纖維炎
• 放電
• 延遲癒合
• 變色
• 可捲曲、出血造粒組織
• 意外疼痛/壓痛
• 傷口底部的口袋/橋接
• 異常氣味
• 傷口分解

An infected wound may not have all of these signs. Recent work has a^empted to validate these criteria; results show pain, followed by wound enlargement to be the most significant features of the infected wound.
受感染的傷口可能沒有所有這些跡象。最近的工作有驗證這些標準的一個條件;結果表明疼痛,隨後傷口增大是受感染傷口最顯著的特徵。

What does resistance mean?
阻力是什麼意思?

Insensitivity to an antimicrobial agent, which may be innate or acquired.
對抗菌劑不敏感,可能是先天或後天。

What is an Antibiotic?
什麼是抗生素?

A chemical substance produced by a micro‐organism which has the capacity, in dilute solutions, to selectively inhibit the growth of, or to kill other micro‐organisms.
一種由微生物和有機體產生的化學物質,具有選擇性地抑制或殺死其他微生物的生長的能力,在稀釋溶液中。

What is a Disinfectant?
什麼是消毒劑?

A non‐selective chemical agent that disinfects by killing or removing micro‐organisms from inert surfaces, used particularly on instruments, work surfaces, etc. and not intended for use on the tissues of the body where its toxicity would impair healing.

一種非選擇性化學劑,通過殺死或去除惰性表面的微生物進行消毒,特別用於儀器、工作表面等。而不是用於身體的組織,其毒性會損害癒合。

What is an Antiseptic?
什麼是防腐劑?

A disinfectant substance that can be used on skin and on wounds that either kills or prevents the multiplication of potentially pathogenic organisms.
Antiseptics can be diluted disinfectants.
Antiseptics have the advantage of rarely selecting for resistant microbial strains, and, being topical do not rely on the bloodstream for access to the wound – this is particularly important in ischaemic wounds. However, they have the possible disadvantage of toxicity to the tissues at higher concentrations (Sco^ Ward and Saffle 1995).

一種消毒物質,可用於皮膚和傷口,殺死或防止潛在致病生物的繁殖。防腐劑可以稀釋消毒劑。防腐劑的優點是很少選擇耐藥微生物菌株,而且,作為局部藥物,不依賴血液進入傷口 - 這在缺血性傷口中尤其重要。然而,它們具有對濃度較高的組織毒性的可能缺點(Sco_Ward和Saffle,1995年)。

What is a Biofilm?
什麼是生物膜?

A microbial colony encased in a adhesive polysaccharide matrix that is usually a^ached to a surface. All wound surfaces are host to fluctuating polymicrobial communities tolerating certain antimicrobial therapy. Biofilms are 90% water, therefore drying the wound with a super absorptive dressing is expected to be effective.
According to Dr. Randall Wolco^, key clinical indicators are:
‐ The presence of slough and exudate
‐ Antibiotic resistance
‐ Failure to heal, with the wound waxing and waning

一種微生物群落,包裹在膠粘劑多糖基質中,通常被包裹到表面。所有傷口表面都承載著波動的多微生物群落,可以容忍某些抗菌治療。生物膜是90%的水,因此乾燥傷口與超級吸收敷料預計將是有效的。
根據Randall Wolco®博士的說法,主要臨床指標是:
‐ 抗生素耐藥性
‐ 無法癒合,傷口打蠟和減弱

What is a Capsule?
什麼是膠囊?

A dense layer of protein or polysaccharide that surrounds a bacterial cell.
圍繞細菌細胞的緻密的蛋白質或多糖層。

What is Endotoxin?
什麼是內毒素?

A lipopolysaccharide toxin which is either intracellular or bound to the bacterial cell.
一種脂多糖毒素,在細胞內或與細菌細胞結合。

What is Exotoxin?
什麼是外毒素?

A toxin released from the bacterium. Both endo‐ and exotoxins cause damage to the host.
從細菌中釋放的毒素。內毒素和外毒素都對宿主造成損害。

What are Virulence factors?
什麼是病毒因素?

Virulence is the degree of pathogenicity and invasiveness of an invading micro‐organism.
The various factors which cause this include toxins, enzymes such as coagulase and collagenase, bacterial antigens, fimbriae, capsule and flagellae.

毒性是入侵微生物的致病性和侵入性程度。造成這種情況的各種因素包括毒素、酶,如凝固酶和膠原酶、細菌抗原、纖維、膠囊和花樣膠原蛋白。