Honey in Wound Healing

There is a long tradition of the use of honey in wound healing. Medical literature from ancient Egypt and Greece as well as the Ayurvedic traditions of India have described the use of honey alone or in combination with other substances as a wound healing agent (43). These traditional applications of honey have evolved into current evidence-based practices in which honey is used as a therapeutic agent to modulate wound healing in a multifactorial way. It promotes debridement, kills bacteria, creates a moist healing environment, and appears to actively promote healing (44).

A systematic review of the use of honey as a wound dressing was undertaken in 2001 (45). This review looked at seven randomized trials using burns of various depths as well as infected postoperative wounds. Comparators were polyurethane film, amniotic membrane, potatoes peel, and silver sulfadiazine. Honey compared favorably with all the comparators and showed a significantly shorter healing period, but the quality of the studies was considered to be low to give a high rating to the confidence of the usefulness of honey as a treatment. Nevertheless, the biological plausibility of such treatment was acknowledged.

Five years later, Molan in a review article revisited the evidence for the use of honey as a wound dressing (46). This was an interesting review written by a person with an established interest in undertaking research and clinical usage of honey. The review details positive findings of the therapeutic applications of honey in 12 randomized controlled trials involving 1965 participants and 5 clinical trials (not randomized) involving 97 participants. Further evidence of the effectiveness of honey on wound healing was detailed in 16 trials involving 533 wounds in animals. It was noted that there were also numerous case reports detailing the efficacy of honey. Of note, there are reports of the success of honey in the treatment of some particularly difficult organisms including Methicillin-resistant Staphylococcus aureas and Vancomycin-resistant enterococci (47). What is particularly interesting however are the comments concerning the abundant clinical evidence to support the use of honey compared with the relative lack of evidence supporting the use of other wound care products.

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