We do not add any vitamins to the ointment base (dark buckwheat honey). Honey contains vitamins by itself: A; B-complex (various types of B), and C-D-E-K. The quality of the honey is important. The honey we use is No. 1 in phenolic compounds. That gives it very strong antibacterial activity (see the research articles by Van den Berg and Brudzynski on our website). We add a blend of metal-ions and trace elements.
You can cover IF ointment with dry gauze. Apply liberally. In general, there is no need to use expensive secondary dressings. For some dry wounds, one may wish to use an occlusive dressing. This effect can be obtained with various different materials generally available. As always, and if practically possible, necrosis removal benefits from frequent application of ointment and dressing changes.
Yes. There is no scientific evidence that cortisone and a (topical) antibiotic cannot be used in conjunction. It is often advised to use a topical antibiotic when a patient is already using cortisone.
Principelle IF and MelMax honey-based dressings: on average, contaminated/infected wounds need 3 dressings per week initially. As the contamination or infection cleans up, 1 dressing each 5-6 days. Most often, wound care nurses have a protocol for the treatment of infected wounds and burns. Results depend on pathology, levels of contamination, comorbidity, vascular circulation, and other medication used, as is the case for every wound treatment product.
Pelsan and Celan are normally used twice daily. They are to be considered skin care products, although intended for specific conditions. They are not wound care products. When used more general, for example as a general moisturizer, the frequency may vary from once daily to once every other day. This normally depends on the type of skin. Oily skin means lower frequency. Usage after showering or bathing gives good results in general.
Yes. Diabetes is a complicated metabolic disorder. The topical application of honey-based wound care products does not influence glycaemic levels. Therefore, the underlying overall situation and complications are not influenced by the use of these products. Furthermore, compared to the consumption (oral ingestion) of honey, there is very little honey in a dressing and its effect is only on the interface between dressing and wound surface, where the product is diluted by wound exudate and exerts its regulating effect on bacterial contamination and infection. In the context of nutrition and food (ingested orally), honey has only a low to moderate glycaemic index (GI). One would need to consume a relative larger amount to see effects. Ingestion of honey as food is not to be compared to it’s use in advanced wound care.
Because honey is a natural product, natural differences can occur while it is produced by our bees – even seasonal differences may be seen in the raw product. However, we always test our honey batches to verify that they all meet the requirements for the product (this is part of our Quality Management system and a vital production policy). Recently, we have adjusted our production protocol to make the contents of the Principelle IF ointment tube more fluid and less likely to crystallise over time, which happens to some forms of honey. This filtering process made the colour of the end product slightly more transparent, but it affects the quality of the product in a positive way. The honey-based dressings or ointment can also turn darker over time. This is caused by the Maillard reaction. During storage over time, minor temperature differences cause this slow, non-enzymatic process in which sugars and amino acids form complex bonds. This causes a dark colour also seen in the production of food causing distinct flavours (not be confused with caramelisation). This process actually increases the total amount of phenolic compounds as shown in laboratory tests throughout the years, and in turn supports the antibacterial capabilities of the honey.
- A) The medical grade Dark Buckwheat Honey (DBH) that we use is superior to Manuka honey. Unlike Manuka, its antibacterial efficacy does not depend on methylglyoxal but is naturally richer in (poly)phenolic compounds, anti-oxidants and hydrogen peroxide, all adding to it’s antibacterial effect. Different kinds of honey have been tested prior to the development of Principelle products and DBH was selected.
- B) We use a higher concentration of honey in our ointments compared to most other honey-based wound products. Whereas others sometimes use (for example) 50% of honey and 50% PEG (polyethyleneglycol, a common solvent), we use up to 98% DBH in our dressings. This costly feature is a challenging factor to compete with other products price wise, but the product will have a significantly stronger effect.
- C) As you might know, we add a formulation of metal ions, minerals, salts and trace elements to our ointments while other honey-based wound products only use honey; or they might add one or two extra simple ingredients. Our formulation is what activates the (chronic or acute) wounds’ natural healing processes while the honey fights off any contamination/infection. In short: it’s not just antibacterial, it actually changes something in the wound environment.
- D) Our honey products are MMP (Matrix-metallo-proteinase) regulating products. In (chronic) wounds, an imbalance of MMP’s is seen: MMP-2 and MMP-9 are significantly upregulated. Our honey-based products with ionogen formulation help (down-)regulate these MMP’s.
Reactive Oxygen Species (ROS, sometimes named “free radicals” although technically that is not entirely correct) are small molecules that are present in wounds. They result from biochemical processes in wounds and cause cell damage. Therefore, the presence of reactive oxygen species is not good. Our products are designed to decrease the number of reactive oxygen species in wounds. This reduces oxidative stress. That is one of the beneficial effects of both Principelle IF and MelMax.