title: A multi-centre clinical evaluation of reactive oxygen topical wound gel in 114 wounds.
abstract: OBJECTIVE
  This article reports the outcomes of the use of Surgihoney RO (SHRO), topical wound dressing in a multi-centre, international setting. The aims were to explore the clinical effects of SHRO, including a reduction in bacterial load and biofilm and improvement in healing in a variety of challenging non-healing and clinically infected wounds.
  
  
  METHODS
  This was a non-comparative evaluation, where both acute and chronic wounds with established delayed healing were treated with the dressing. Clinicians prospectively recorded wound improvement or deterioration, level of wound exudate, presence of pain, and presence of slough and necrosis. Analysis of this data provided information on clinical performance of the dressing. Semi-quantitative culture to assess bacterial bioburden was performed where possible.
  
  
  RESULTS
  We recruited 104 patients, mean age 61 years old, with 114 wounds. The mean duration of wounds before treatment was 3.7 months and the mean duration of treatment was 25.7 days. During treatment 24 wounds (21%) healed and the remaining 90 (79%) wounds improved following application of the dressing. No deterioration in any wound was observed. A reduction in patient pain, level of wound exudate and in devitalised tissue were consistently reported. These positive improvements in wound progress were reflected in the wound cultures that showed a reduction in bacterial load in 39 out of the 40 swabs taken. There were two adverse events recorded: a stinging sensation following application of the dressing was experienced by 2 patients, and 2 elderly patients died of causes unrelated to the dressing or to the chronic wound. These patients' wounds and their response to SHRO have been included in the analysis.
  
  
  CONCLUSIONS
  SHRO was well tolerated and shows great promise as an effective potent topical antimicrobial in the healing of challenging wounds.
  
  
  BACKGROUND
  Matthew Dryden has become a shareholder in Matoke Holdings, the manufacturer of Surgihoney RO, since the completion of this study. Keith Cutting is a consultant to Matoke Holdings.
authors.affiliation: Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.|Winchester and Rare and Imported Pathogens Dept PHE, Porton, UK.
authors.forename: M
authors.initials: M
authors.lastname: Dryden
authors.affiliation: Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
authors.forename: A
authors.initials: A
authors.lastname: Dickinson
authors.affiliation: University of Hull.
authors.forename: J
authors.initials: J
authors.lastname: Brooks
authors.affiliation: Wound Clinic London.
authors.forename: L
authors.initials: L
authors.lastname: Hudgell
authors.affiliation: Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
authors.forename: K
authors.initials: K
authors.lastname: Saeed
authors.affiliation: Hertfordshire, UK.
authors.forename: K F
authors.initials: KF
authors.lastname: Cutting
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D018441:Biofilms; D015331:Cohort Studies; D017719:Diabetic Foot / Q000188:drug therapy*; D005260:Female; D005782:Gels / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000188:drug therapy*; D014945:Wound Healing; D014947:Wounds and Injuries / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D005782:Gels
keywords: RO Surgihoney; acute wound; chronic wound; clinical evaluation; topical antimicrobial gel