Honey wound dressings may delay healing in diabetes

NewsBot · Jul 29, 2011

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Methylglyoxal—A Potential Risk Factor of Manuka Honey in Healing of Diabetic Ulcers
Juraj Majtan
Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 295494,

Honey has been considered as a remedy in wound healing since ancient times. However, as yet, there are inadequate supportive robust randomized trials and experimental data to fully accept honey as an effective medical product in wound care. Manuka honey has been claimed to have therapeutic advantages over other honeys. Recently, it has been documented that the pronounced antibacterial activity of manuka honey is due, at least in part, to reactive methylglyoxal (MG). The concentration of MG in manuka honeys is up to 100-fold higher than in conventional honeys. MG is a potent protein-glycating agent and an important precursor of advanced glycation end products (AGEs). MG and AGEs play a role in the pathogenesis of impaired diabetic wound healing and can modify the structure and function of target molecules. This commentary describes the concern that MG in manuka honey may delay wound healing in diabetic patients. Further detailed research is needed to fully elucidate the participation of honey/derived MG in healing diabetic ulcers. We advocate randomized controlled trials to determine efficacy and safety of manuka honey in this population.
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Full text of article

7. Conclusion
A number of randomized clinical trials suggest that medical grade honey promotes wound healing but most of them have not included diabetic patients with chronic leg ulcers and nearly three-quarters of clinical trials have focused on the use of honey for acute wounds, in particular burns. In general, repair of tissue damage in diabetic foot disease is accompanied with several pathophysiological mechanisms. Since manuka honey contains high levels of MG, we speculate that patients with diabetes may be at risk due to either the direct negative effect of MG on cells and components in the wound or the indirect formation of AGEs, which could impair the wound-healing process.We believe that honey is an effective alternative dressing for treatment of many types of chronic wounds. However, MG may have a detrimental effect on diabetic ulcers. Further research is needed to fully elucidate the effect of honey-derived MG in the treatment of diabetic ulcers. In addition, honeys with varying levels of MG should be subjected to randomized comparative clinical trials in treatment of diabetic ulcers.
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Admin2 · Jul 29, 2011

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NewsBot · Oct 19, 2012

Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers
Alexandros V. Kamaratos, Konstantinos N. Tzirogiannis, Stella A. Iraklianou, Georgios I. Panoutsopoulos4, Ilias E. Kanellos, Andreas I. Melidonis
International Wound Journal; Early View

In this study, we investigate the effect of manuka honey-impregnated dressings (MHID) on the healing of neuropathic diabetic foot ulcers (NDFU). A total of 63 Caucasian, type 2 diabetic patients followed up in the diabetic foot outpatient clinic comprised the study population. Patients were randomised in two groups as follows: group I patients were treated with MHID and group II patients were treated with conventional dressings (CD). The patients were followed up on a weekly basis for 16 weeks. Mean healing time was 31 ± 4 days in group I versus 43 ± 3 days in group II (P < 0·05). In group I patients 78·13% of ulcers became sterile during the first week versus 35·5% in group II patients; the corresponding percentages for weeks 2, 4 and 6 were 15·62% versus 38·7%, 6·25% versus 12·9% and 0% versus 12·9% respectively. The percent of ulcers healed did not differ significantly between groups (97% for MHID and 90% for CD). MHID represent an effective treatment for NDFU leading to a significant reduction in the time of healing and rapid disinfection of ulcers.
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NewsBot · Sep 26, 2018

Effectiveness of honey dressing in the treatment of diabetic foot ulcers: A systematic review and meta-analysis
CuiWangMinGuoNanZhangGongchaoWang
Complementary Therapies in Clinical Practice; 21 September 2018

Objective
Honey dressing has been applied in the treatment of diabetic foot ulcers (DFUs). However, there is a lack of research showing ample evidence that honey dressing is more effective in the treatment of DFUs than other dressings. This study aimed to examine the effects of honey dressing on wound-healing process for DFUs.

Method
We searched for evidence regarding honey dressing used in the treatment of DFUs in various databases. We selected randomized controlled trials (RCTs) and quasi-experimental studies for meta-analysis.

Results
The meta-analysis showed that honey dressing effectively shortened the wound debridement time, wound healing time, and bacterial clearance time; it increased the wound healing rate and bacterial clearance rate during the first one to two weeks of use.

Conclusion
Our findings suggest that honey dressing effectively promotes healing in DFUs. Further research is needed to elucidate these findings so that this form of treatment can be widely applied.
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NewsBot · Feb 5, 2019

Effectiveness of honey dressing in the treatment of diabetic foot ulcers: A systematic review and meta-analysis.
Wang C et al
Complement Ther Clin Pract. 2019 Feb;34:123-131.

OBJECTIVE:
Honey dressing has been applied in the treatment of diabetic foot ulcers (DFUs). However, there is a lack of research showing ample evidence that honey dressing is more effective in the treatment of DFUs than other dressings. This study aimed to examine the effects of honey dressing on wound-healing process for DFUs.

METHOD:
We searched for evidence regarding honey dressing used in the treatment of DFUs in various databases. We selected randomized controlled trials (RCTs) and quasi-experimental studies for meta-analysis.

RESULTS:
The meta-analysis showed that honey dressing effectively shortened the wound debridement time, wound healing time, and bacterial clearance time; it increased the wound healing rate and bacterial clearance rate during the first one to two weeks of use.

CONCLUSION:
Our findings suggest that honey dressing effectively promotes healing in DFUs. Further research is needed to elucidate these findings so that this form of treatment can be widely applied.
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NewsBot · Jun 14, 2019

Impact of olive oil and honey on healing of diabetic foot: a randomized controlled trial.
Karimi Z et al
Clin Cosmet Investig Dermatol. 2019 May 9

Background: This study aimed 1) to examine the impact of honey on diabetic foot; 2) to examine the effect of olive oil on diabetic foot; and 3) to compare the impact of honey and olive oil in the healing of diabetic foot. Methods: In this randomized controlled trial, 45 patients took part. Patients were randomly assigned to three groups. In the honey group, the wound was dressed using gauzes with honey daily for 1 month. In the olive oil group, the wound was dressed using gauzes with olive oil (4 mL) daily for 1 month. Patients in the control group received usual dressing. Wounds were assessed before and after intervention using the Wagner scoring system and the checklist of diabetic foot healing (where a higher score indicates better wound healing). Results: Demographic characteristics of patients in the three groups were similar. Mean scores of tissue around the wound, wound grade, wound drainage, and wound healing were similar before intervention in all three groups. After intervention, means score of tissue around the wound, wound grade, wound drainage, and wound healing were significantly higher in patients in the honey and olive oil groups compared to patients in the control group. Conclusion: The results of this study reveal that honey is as effective as olive oil in the treatment of diabetic foot. Given the few studies on this topic, further investigation is needed.
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NewsBot · Apr 13, 2020

HONEY DRESSING IN WOUND TREATMENT: A SYSTEMATIC REVIEW
Ayse CelikYilmazDilekAygin
Complementary Therapies in Medicine; 2 April 2020, 102388

Highlights
•The most characteristic role of honey in wound healing is the prevention and limitation of bacterial infection, thus reducing the bio-burden of the wound.
•Honey contains a protease enzyme that induces scar tissues to initiate autolytic debridement. Honey uses its intense osmolytic strength to attract lymphatic fluid to the scar tissue and thus creates the humid environment required to automatically remove the dead, damaged or infected scar tissues.
•Honey is frequently used in the treatment of chronic wounds, especially diabetic foot injuries, decubitus ulcers, venous and arterial ulcers.
•The area of usage of honey by clinicians has increased considering all the advantages of honey and research results on it. In conclusion, honey dressing is a natural product that can be used for acute and chronic wounds.
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Objective
The use of honey for wound treatment and care purposes is based on thousands of years of history. The development of science and in vitro/in vivo studies have demonstrated that honey contributes to wound healing by showing therapeutic effects by means of the bioactive compounds it contains. The aim of this systematic review was to evaluate the place of honey in wound treatment by investigating the randomized controlled studies.

Method
30 publications which were obtained as a result of the scans in the databases and which comply with the evaluation criteria were included in the review.

Results
In the results of the study, it was reported that honey in acute and chronic wounds provided rapid epithelization and wound contraction in wound healing, had anti-inflammatory and debridement effect, decreased the pain, ensured infection control, shortened the time of wound healing and was cost-effective.
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NewsBot · May 6, 2020

Comparison of honey and natural ointment based on honey-tea tree oil on the healing of diabetic foot ulcer.
Aryani R et al
Enferm Clin. 2020 Mar;30 Suppl 3:14-17

OBJECTIVES:
This study aimed to compare the impact of honey and natural ointment based on honey-Tea Tree Oil.

METHODS:
This was a quasi-experimental study with a pre-post control group design approach. The sample consisted of 27 respondents in two different wound care clinics. The instruments used were the Leg Ulcer Measurement Tool (LUMT) measured on day 1, 7 and 14. Data was analyzed using paired t-test, pooled t-test, and multiple regression test.

RESULTS:
Most participants were female, the average age was 50.89 years, the average duration of illness for type II diabetes was 3.56 and had current infection. The results showed a significant difference in LUMT score between before and after treatment of wounds healing in the two intervention groups (p-value=0.000).

CONCLUSION:
Honey and natural ointment based on honey - tea tree oil significantly contributed to the healing of Diabetic Foot Ulcer.
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NewsBot · Jun 23, 2021

Therapeutic Properties of Honey for the Management of Wounds; Is There a Role in the Armamentarium of Diabetic Foot Ulcer Treatment? Results From In vitro and In vivo Studies
Ioanna A Anastasiou et al
Int J Low Extrem Wounds. 2021 Jun 18;15347346211026819

Diabetic foot ulcers are one of the most dreadful complications of diabetes mellitus and efforts to accelerate diabetic wound healing are of paramount importance to prevent ulcer infections and subsequent lower-limb amputations. There are several treatment approaches for the management of diabetic foot ulcers and honey seems to be a safe and cost-effective therapeutic approach on top of standard of care. The aim of this review was to summarize the therapeutic properties of honey and the data regarding its possible favorable effects on diabetic wound healing. A literature search of articles from 1986 until April 2021 was performed using MEDLINE, EMBASE, and the Cochrane Library to assess for studies examining the therapeutic wound healing properties of honey, it's in vitro effect, and the efficacy and/or mechanism of action of several types of honey used for the treatment of diabetic animal wounds. Honey has antioxidant, anti-inflammatory, and antibacterial properties and in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models show that treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing. The use of honey could be a promising approach for the management of diabetic foot ulcers.
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NewsBot · Aug 30, 2021

Medical-Grade Honey as an Alternative Treatment for Antibiotics in Non-Healing Wounds-A Prospective Case Series
Adéla Holubová et al
Antibiotics (Basel). 2021 Jul 28;10(8):918

Non-healing wounds are usually colonised by various types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical-grade honey (MGH), which favourably affects the healing process with its antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory properties. The objective of this study was to evaluate the effect of MGH therapy on the healing process of non-healing wounds of various aetiologies and different wound colonisations. Prospective, observation-intervention case studies (n = 9) of patients with wounds of various aetiologies (venous leg ulcers, diabetic foot ulcers, surgical wound dehiscence) are presented. All wounds were treated with MGH and the healing trajectory was rigorously and objectively monitored. In all cases, pain, odour, and exudation were quickly resolved, which led to an improvement in the quality of life of patients. Despite the proven bacterial microflora in wounds, antibiotic treatment was not necessary. The effects of MGH alleviated the signs of local infection until their complete elimination. In eight out of nine cases, the non-healing wound was completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in wounds of various aetiologies and forms an effective alternative for the use of antibiotics for treating locally infected wounds.
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NewsBot · Aug 17, 2022

Honey dressing: a missed way for orthopaedic wound care
Abdel-Salam Abdel-Aleem Ahmed et al
Int Orthop. 2022 Aug 16

Purpose: Orthopaedic-related wounds are critical situations calling for care to avoid deep infections and its consequences. The purpose of this study was to evaluate the efficacy of using honey for care of orthopaedic-related wounds with limited resources.

Patients and methods: This prospective study included 50 cases with an average age of 38.18 (range 17-63) years with 38 males and 12 females. The most frequent wound location was the leg (41 patients; 82%), then the foot (six patients; 12%), and the ankle in three patients (6%). The aetiologies were open fractures (34 cases; 68%), infected tibial non-unions (nine cases; 18%), and post-operative infections (seven cases; 14%). Exposed tendon was present in three cases. Bone exposure was present in two cases. Deep infection was present in 29 cases (58%). Besides treating the primary cause, a ribbon of gauze soaked with honey was applied to the wounds after thorough saline washing.

Results: Wound sizes were variable. All cases showed improvement in all parameters with complete wound healing and full coverage of bone and tendons. Recurrence of deep infection occurred in three cases and treated by debridement. One case needed sequestrectomy of a small exposed tibial cortical fragment. Exposed tendon cases showed superficial necrosis which was treated by simple debridement. Initial mild itching occurred in five patients with spontaneous resolution.

Conclusion: With treating the underlying aetiology and optimising the patient's general condition, honey was an effective, simple, and affordable method of wound care in different orthopaedic conditions even with exposed bone or tendons.
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NewsBot · Oct 28, 2022

Honey for wound treatment — is it really effective?

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