The use of honey in wound care dates back millennia. There are records of the Sumerians using honey in wound care as far back as 4,000 years ago with the Egyptians improving upon this method by impregnating different materials with honey for application to wounds. [1] With the advent of modern antibiotics in the early 20^th century the use of honey fell out of favor. An effort to use more natural and renewable resources has brought honey back into focus as a viable wound care option. [2] How effective honey can be in wound healing and the appropriate application of honey to wounds is the focus of this article today.

Numerous studies have been performed and reviewed in an effort to qualify the effectiveness of honey in wound healing and antimicrobial properties. No specific type of honey was indicated. One study demonstrated that the use of honey on a wound improved healing by 40 days. Honey resulted in wound healing in 100 days while conventional wound dressing took 140 days. The bio burdens (infectious microbes) of wounds in one study were eradicated in periods of 3-6 days, 7 days and 7-10 days respectively, which resulted in the wounds being classified as sterile. Additionally, even gangrenous tissue was replaced with granulating tissue. [3]

In addition to wound care honey has also been shown to prevent tumor implantation (TI) during laparoscopic studies for tumor removal. Preventing the migration of malignant tissue into other areas of a body cavity can impact patient prognosis. [2]

The standard bearer for honey used in wound care is Manuka honey. This honey is indigenous to New Zealand and Australia. This type of honey has been shown to have the most significant affect on wound healing and microbial destruction. Another effective honey is Tualang from Malaysia is proving to be beneficial in wound care. When Aquacel dressings had Manuka or Tualang honey were compared with Aquacel plain and Aquacel-AG. Fairly comparable results were obtained with the Aquacel-Ag and Aquacel-Manuka showing the greatest area in microbe inhibition over Aquacel Tualang with Gram-positive bacteria. The Manuka and Tualang dressings performed equally on Gram-negative bacteria. [3]

Another area where the use of honey has become more prevalent is in the treatment of burns. The use of silver sulfadiazine (SSD) is quite common for the treatment of infections in burn wounds. The increase of anti-biotic resistance has lead to seeking other sources for infections. In one clinical trial the average rate of healing for honey treated wounds (no specific honey identified) was 21 days in comparison to 24 days for SSD. Additionally, Pseudomonas aeroginsa infection rates were 6 for the honey treated wounds versus 27 for the SSD-treated wounds. [4]

While many factors can affect the efficacy of honey, e.g. age, sex, type of microbe and type of honey used, there is strong evidence to support the use of honey in wound care. [3] Whether it is applied in liquid form directly to a wound or embedded in a commercially produced dressing it has proven to be an important component of wound care while reducing the need for artificially produced antibiotics. [5] [2]. What was known thousands of years ago by Sumerians and Egyptians has been rediscovered by traditional medicine and should be considered a frontline treatment in difficult to heal wounds. By seeking knowledge from our peers, whether through formal seminars or instructional articles and materials, clinicians strive to provide the best of evidenced-based practice. That may just mean discovering an ancient treatment can be a modern wonder.

Sources

[1] Beyond Wet-to-Dry: A Rational Approach to Treating Chronic Wounds. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680240/. Eplasty. 2009; 9: e14. Published online 2009 April 13. Johnson C. Lee, BA,^aSwetha Kandula, MD,^b,c and Noëlle S. Sherber, MD^c

[2]Honey: Nutritional and Medicinal Value. https://www.medscape.com/viewarticle/565913_print. Int J Clin Pract. 2007;61(10):1705-1707. F. R. Khan, Z. Ul. Abadin, N. Rauf

[3]Standardized antibacterial honey (Medihoney) with standard therapy in wound care: randomized clinical trial. J Adv Nurs. 2009 Mar;65(3):565-75. https://www.ncbi.nlm.nih.gov/pubmed/19222654.

[4]Honey compared with silver sulfadiazine in the treatment of superficial partial-thickness burns. Int Wound J. 2010 Oct;7(5):413-7. .https://www.ncbi.nlm.nih.gov/pubmed/20649832. Malik KI, Malik MA, Aslam A.

[5]Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study. BMC Complement Altern Med. 2010; 10:31. Published online 2010 June 24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908556/. Nur-Azida Mohd Nasir,^#1Ahmad Sukari Halim, ^#1Kirnpal-Kaur Banga Singh,²Ananda Aravazhi Dorai,¹ and Mehru-Nisha Muhammad Haneef²strong