Honey as a Dressing for Wounds, Burns, and Ulcers (Part 2).

Honey is a highly concentrated sugar solution produced by honey bees, primarily from the nectar of plants. It is composed of carbohydrates (sugars), water, enzymes, amino acids, pigments, pollen, wax, and other trace constituents from both bees and plants. Honey has been used in the treatment of burns and wounds for many centuries, with documents describing this use dating back to 1700 BC.

Honey as a Dressing for Wounds, Burns, and Ulcers: A Brief Review of Clinical Reports and Experimental Studies.

Mode of Application of Honey.

The procedure that is described in most of the reports is to clean the wound first, even though many describe honey as having a cleansing and debriding action on wounds. Some report abscesses being opened and pockets of pus drained , and necrotic tissue being removed , before dressing wounds with honey.

A number of properties inherent to honey might contribute to its ability to fight infection and promote healing. Its high sugar content allows it to draw infection and fluid from wounds by a process called “osmosis.” Honey prevents bacterial growth through its acidic pH and through the work of an enzyme that produces small amounts of hydrogen peroxide. Its ability to keep the area around a wound moist and protected promotes fast healing and prevents scarring.

Some used rigorous cleansing procedures: scrubbing with a soft toothbrush followed by hydrogen peroxide, saline rinse, betadine, and another saline rinse ; dilute Dakin solution or dilute hydrogen peroxide on the wound bed and alcohol on the surrounding skin ; or the wounds were cleaned with eusol or aqueous 1% chlorhexidine. Some reported cleaning the wounds before dressing, but did not specify with what. One cleaned the wounds with gauze. Most report simply washing wounds with saline before dressing with honey , and when dressings are changed.

Honeys also contain components from the specific plants used by the bees in their production, and it is speculated that some of these components might further add to the antibacterial and wound-healing effects of certain honeys. The process of pasteurization, used to sterilize commercial honeys, destroys the enzyme involved in the production of hydrogen peroxide, rendering these honeys less antibacterial. Raw honeys maintain their enzymes, and honeys produced for therapeutic use are sterilized through an irradiation process that does not damage their constituents. There are currently two therapeutic honeys available: Medihoney of Australia and Active Manuka Honey of New Zealand. Both are derived from bees using the flowers of tea trees (Leptospermum spp.) as their source.

In many of the reports the honey is spread on the wound then covered with a dry dressing, mostly gauze. The quantity of honey used varies: one reported using a thin smear of honey ; two reported using a thin layer honey ; most just refer to the honey being spread or poured over the wound ; others report using a thick layer of honey , soaking the wound generously with honey , pouring honey into the wound to three-quarters fill , and applying 15-30 ml of honey to ulcers. Others have applied the honey to the dressing then placed it on the wound: either the honey was spread on gauze or the gauze was soaked in honey , or "honey pads" were used.

Honey-impregnated gauze has also been used to pack cavities of wounds. Others have packed cavities of wound directly with honey and then covered the wound. Cervical ulcerations stubborn to healing have been treated by inserting 85 ml honey in the vagina and holding this in place with a tampon for 3 days.

A number of studies have confirmed the antibacterial effects of honey in test tubes. One study found that different honeys had different levels of activity against specific bacteria. Studies on humans have reported that honey used as a wound dressing reduced infection, inflammation, pain, and odor, and promoted easy removal of dead tissue and rapid healing with little scarring.

Mostly the dressings are changed daily or every 2 days : or every 2 - 3 days. One paper reported that dressings were changed daily, but that less frequent changes were needed if the wounds were clean and dry. Another reported dressings being changed once or twice daily until clean granulated wounds were achieved, then once-daily changes. Others have reported changing honey dressings twice daily , 2 - 3 times a day , 3 times daily , and 3 times daily if contaminated with urine or faeces, otherwise twice daily.

Fifty-nine people with chronic wounds and ulcers participated in one preliminary study described in this review. The group included people with diabetic ulcers, burns, traumatic ulcers, gangrene, and other types of wounds. All had been treated with commercial wound dressings and antibiotics for periods of between one month and two years without results. Although 51 of the 59 wounds had been infected prior to honey treatment, all were free of infection within one week of starting honey dressing applications. In addition, inflammation and odor were markedly reduced and healing rapidly ensued.

Two papers report mixing lipid material with the honey to make it easier to spread; either castor oil or 20% vaseline or lard. Although this was a common form of wound dressing in ancient times, it is not necessary as honey can be made very fluid by warming to 37°C if vigorous stirring is not sufficient. Bulman refers to using liquid honey on large surfaces, or carefully warming granulated honey..

Clinical Observations.

It has been reported from various clinical studies on the usage of honey as a dressing for infected wounds that the wounds become sterile in 3 - 6 days , 7 days or 7 - 10 days. Others have reported that honey is effective in cleaning up infected wounds. It has also been reported that honey dressings halt advancing necrosis. Honey has also been found to act as a barrier preventing wounds from becoming infected , preventing cross-infection , and allowing burn wound tissue to heal rapidly uninhibited by secondary infection.

Other studies have compared honey with other wound treatments. In one such study, honey was found to be as effective as, or more effective than, silver sulfadiazine (SSD), one of the most common topical treatments for burns. Fifty participants with superficial burns were randomly assigned to have their burns dressed with honey or SSD. Those treated with honey experienced faster reduction in inflammation and better infection control. Eighty-four percent of those treated with honey had satisfactory healing within 7 days and 100% by day 21, whereas 72% of those treated with SSD had satisfactory healing after 7 days and 84% by day 21. In another controlled trial, 900 participants with partial-thickness burns were randomly assigned to receive either honey dressings or other dressings. Honey was applied directly to the burns and covered with sterile dressings on alternate days. Those whose burns were treated with honey had faster healing and less scarring than those treated with other dressings. In the case of full-thickness burns, however, honey has been found to be inferior to other treatments.

It has been reported that sloughs, gangrenous tissue and necrotic tissue are rapidly replaced with granulation tissue and advancing epithelialisation when honey is used as a dressing , thus a minimum of surgical debridement is required. It has been observed that under honey dressings sloughs, necrotic and gangrenous tissue separated so that they could be lifted off painlessly , and others have noted quick and easy separation of sloughs and removal of crust from a wound.

Rapid cleansing and chemical or enzymic debridement resulting from the application of honey to wounds have also been reported , with no eschar forming on burns. Several other authors have noted the cleansing effect of honey on wounds. It has also been noted that dirt is removed with the bandage when honey is used as a dressing, leaving a clean wound. Honey has also been reported to give deodorisation of offensively smelling wounds.

Honey used as a wound dressing has been reported to promote the formation of clean healthy granulation tissue , allowing early grafting on a clean clear base. It has also been reported to promote epithelialisation of the wound. Dumronglert commented that the rapid growth of new tissue is remarkable. Improvement of nutrition of wounds has been observed , also increased blood flow has been noted in wounds , and free flow of lymph.

This comprehensive review describes the enormous potential for honey as a therapeutic tool in the treatment of wounds and burns. It is nontoxic and inexpensive, and, despite theoretical concerns about introducing infection through the application of honey, no infections or other negative side effects have been noted. Further studies may help elucidate which specific honeys are most effective for the various types of wounds and burns... [read more]

Several authors have commented on the rapidity of healing seen with honey dressings. Descottes refers to wounds becoming closed in a spectacular fashion in 90% of cases, sometimes in a few days. Burlando refers to healing being surprisingly rapid, especially for first and second degree burns. Blomfield is of the opinion that honey promotes healing of ulcers and burns better than any other local application used before. Bergman has observed clinically that healing in open wounds is faster with honey, as has Hamdy who also found that it accelerated making wounds suitable for suture.

Tuberculosis.
Honey helps patients suffering from Tuberculosis as it vastly helps in arresting the spread of this disease.

It has been noted that dressing wound with honey allows early grafting on a clean clear base , with prompt graft taking. It has also been reported that it reduces the incidence of skin graft areas and helps skin regenerate, making plastic reconstruction unnecessary.

Asthma. Honey helps in conditions of Asthma as many conditions of Asthma respond favourably to Honey.

Others also have noted that skin grafting is found to be unnecessary. It has also been reported that dressing wounds with honey gives little or no scarring.

Fatigue and exhaustion.
Honey is best used to increase the physical stamina & energy level of the human body & since honey is easily absorbed in the blood, it is the best ingredient to remove tiredness ad fatigue after hard work almost instantly.Dissolve 1 teaspoon honey in warm water or quarter honey balance of water in a jug and keep in the fridge. Honey is primarily fructose and glucose and so it is quickly absorbed by the digestive system.

Another effect of honey on wounds that has been noted is that it reduces inflammation and hastens subsidence of passive hyperaemia. It also reduces oedema and exudation , absorbing fluid from the wound. Honey is reported to be soothing when applied to wounds ] and to reduced pain from burns , in some cases giving rapid diminution of local pain.

Honey is reported to cause no pain on dressing or to cause only momentary stinging , to be non-irritating , to cause no allergic reaction , and to have no harmful effects on tissues.

Osteoporosis.
1 teaspoon of honey a day helps calcium utilization and prevents osteoporosis. Essential from age 50 onwards.

It has been noted that honey dressings are easy to apply and remove. There is no adhesion to cause damage to the granulating surface of wounds , no difficulty removing dressings , and no bleeding when removing dressings. Any residual honey is easily removed by simple bathing.