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Honey in wound care

Author: Vanessa Ngan, Staff Writer, 2005.


Honey in wound care — codes and concepts
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Introduction

For centuries now 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. 

How does honey work to treat infections?

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

Feature Antimicrobial action
High osmolality Honey is a saturated or supersaturated solution of sugars that has strong interaction with water molecules. The lack of ‘free’ water inhibits the growth of microorganisms.
Hydrogen peroxide When honey is diluted by wound exudates, hydrogen peroxide is produced via a glucose oxidase enzyme reaction. This is released slowly to provide antibacterial activity but does not damage tissue. However, acidity, catalase and protein-digesting enzymes in wound fluids may reduce the effectiveness of hydrogen peroxide.
Antibacterial phytochemicals Some kinds of honey still have antimicrobial activity even when hydrogen peroxide activity has been removed. The honey from mānuka trees (Leptospermum scoparium) has been found to have high levels of antibacterial phytochemicals.

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

What is honey used to treat?

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

In most cases, honey is used when conventional antibacterial treatment with antibiotics and antiseptics are ineffective. Inflammation, swelling and pain subside, unpleasant odours stop, and debridement is enhanced as the honey dressings remove dead tissue painlessly and without causing damage to the regrowing cells.

Honey can also be used as first aid treatment for burns as it has anti-inflammatory activity.

What honey should be used?

For centuries it has been known that different types of honey exhibit differences in antibacterial activity. In recent years, honey from different sources have been studied and a few have been identified as having particularly high antibacterial activity. Mānuka honey gathered from the mānuka tree Leptospermum scoparium, native to New Zealand, has high antibacterial activity, with about half of this type of honey having high levels of non-peroxide activity. 

Honey produced from mānuka trees is tested for antibacterial activity and is given a potency rating called a UMF (Unique Mānuka Factor). The honey is tested for the key signature compounds leptopsperin, methylglyoxal and dihydroxyacetone. The higher the UMF rating, the greater the level of UMF properties.

Medical grade UMF honey is sterilised by gamma irradiation without loss of any antibacterial activity.  

How to use honey on wounds

The following are general tips on how honey may be used for wound care.

  • Sterilised, laboratory-tested honey for medicinal purposes should be used to treat infected wounds
  • The amount of honey used depends on the amount of fluid exuding from the wound. Large amounts of exudate require substantial amounts of honey to be applied
  • The frequency of dressing changes depends on how rapidly the honey is being diluted by the exudate. This should become less frequent as the honey starts to work on healing the wound.
  • Occlusive dressings help to prevent honey oozing out from the wound.
  • It is best to spread the honey on a dressing and apply this to the wound than apply the honey directly onto the wound. Dressing pads pre-impregnated with honey are commercially available and provide an effective and less messy alternative.
  • Abscesses, cavity or deep wounds need more honey to adequately penetrate deep into the wound tissues. The wound bed should be filled with honey before applying the honey dressing pad.

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