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Honey in wound care

Introduction

For centuries, honey has been used as an effective remedy for wounds, burns and ulcers. In recent years there has been renewed interest in the medicinal properties of honey. Much of this research is carried out by a team of people working at the Honey Research Unit in Waikato, New Zealand.

How does honey work to treat infections?

There are many characteristics in the composition of honey that together combine to give it its antimicrobial properties.

Characteristic Antimicrobial action
High osmolality Honey is a saturated or supersaturated product solution of sugars that have a strong interaction with water molecules. The lack of “free” water inhibits the growth of microorganisms.
Hydrogen peroxide When honey is diluted with a wound exudates, hydrogen peroxide is produced through a glucose oxidase enzyme reaction. This is released slowly to provide antibacterial activity but does not damage the tissue.
Antibacterial phytochemicals Some types of honey still have antimicrobial activity even when the hydrogen peroxide activity has been removed. Honey from Manuka trees (Leptospermum scoparium) has been found to have high levels of this antibacterial phytochemical.

In addition to its antimicrobial properties, honey also appears to stimulate lymphocytic and phagocytic activity. These are key immune responses of the body in the battle against infection.

What is used to treat honey?

Honey is most commonly used as current antibacterial agent to treat infections in a wide range of wound types. These include:

  • leg ulcers
  • Pressure ulcers
  • Diabetic foot ulcers
  • Infected wound as a result of injury or surgery

  • Burns

In most cases, honey is used when conventional antibacterial treatment with antibiotics and antiseptics is not effective. Numerous studies have shown that these difficult-to-heal wounds respond well to honey dressings. Inflammation, swelling and pain decrease quickly, unpleasant odors stop, debridement is improved as honey dressings remove dead tissue painlessly and without harming regrowing cells. Honey promotes rapid healing with minimal scarring.

Honey can also be used as a first aid treatment for burns as it has a powerful antiinflammatory exercise.

What honey should be used?

It has been known for centuries that different types of honey exhibit differences in antibacterial activity. In recent years, honey from different sources has been studied and some have been identified as having particularly high antibacterial activity. Manuka honey collected from the manuka tree Leptospermum scoparium, native to New Zealand, has exceptionally high antibacterial activity, with approximately half of this type of honey having high levels of non-peroxide activity (i.e., high levels of antibacterial phytochemical activity present). It is important that honey has this additional antibacterial component without peroxide such as factors such as acidity, catalase and protein digestion. enzymes in wound fluids, all work to reduce the antibacterial effectiveness of hydrogen peroxide.

For the treatment of infected wounds, it is important that sterilized and laboratory-tested honey be used for medicinal purposes. Honey produced from manuka trees is tested for antibacterial activity and given a potency rating called UMF (Unique Manuka Factor). The higher the UMF rating, the higher the level of antibacterial activity. Medical professionals in New Zealand use active manuka honey with a UMF rating of 10 or higher. UMF-rated honey is also sterilized by gamma irradiation without loss of antibacterial activity.

How to use honey on wounds

Your doctor should see all difficult-to-heal wounds. The following are general tips on how honey can be used for wound care.

  • The amount of honey used depends on the amount of fluid coming out of the wound. Large amounts of exudate require substantial amounts of honey to be applied.
  • The frequency of dressing changes depends on how quickly the exudate dilutes the honey. This should become less frequent as the honey begins to work on healing the wound.
  • Occlusive The dressings help prevent honey from leaking out of the wound.
  • It is better to spread the honey on a dressing and apply this to the wound than to apply the honey directly to the wound. Honey pre-impregnated bandage pads are commercially available and provide an effective and less messy alternative.
  • Abscesses, cavity or deep wounds need more honey to properly penetrate the wound tissues. The wound bed should be filled with honey before applying the honey dressing.