Evaluation of the effect of local propolis application on the healing of pressure ulcers

This study was conducted as a randomized controlled experimental research to evaluate the effect of local propolis application on the healing of pressure ulcers. Patients who were receiving inpatient care in the Palliative Care and Intensive Care Units of the Ministry of Health Ordu University Training and Research Hospital, located in the central district of Ordu, constituted the study population. The sample size was determined using G*Power analysis, and a total of 62 patients, with 31 in each group, were included in the study. Patients were randomly assigned to either the propolis group or the control group using a simple randomization method. In the propolis group, a spray formulation containing 30% pure Anatolian propolis was applied once daily to the wound area for 21 days. The control group received standard wound care in accordance with the hospital protocol. Wound healing was evaluated using variables such as wound surface area, exudate amount, tissue type, wound stage, total Pressure Ulcer Scale for Healing (PUSH) score, and pain levels (VAS: Visual Analog Scale or FPS: Faces Pain Scale). For data analysis, the Kolmogorov-Smirnov test was used to assess the normality assumption. Within-group changes over time were analyzed using the Friedman and Wilcoxon tests; between-group comparisons were made using the Mann-Whitney U test and t-test. Categorical variables were analyzed with the Chi-square or Fisher's exact tests, and multiple linear regression analysis was used to determine the factors affecting PUSH score change. Additionally, effect size values were calculated using Cohen's d and the r coefficient. According to the findings, statistically significant improvements were observed in the propolis group at the end of the 21-day period in terms of wound surface area, tissue type, exudate amount, wound stage, total PUSH score, and pain levels (p<0.05). While wound stages regressed in the propolis group, they remained stable or worsened in the control group. Moreover, Foley catheter use and total protein levels were identified as significant predictors affecting PUSH score change (p<0.05). In conclusion, local propolis application has been found to be effective in the healing of pressure ulcers; it positively influences wound tissue parameters and patient comfort, and this effect is also supported by recent literature findings. Therefore, the use of propolis as a complementary treatment approach is recommended in routine clinical practice.