It was noted that the honey delimited the boundaries of the wounds andcleansed the wounds rapidly to allow this. Of the 33
patients treated only withhoney dressings, 29 were healed successfully, with good quality healing, in anaverage time of 5 - 6 weeks. Three deaths occurred in the group treated by theorthodox method, whereas no deaths occurred in the group treated with honey.The need for anaesthesia and expensive surgical operation was obviated with theuse of honey. Response to
treatment and alleviation of morbidity were faster inthe group treated with honey. Residual scars were noted in 8% of patientstreated with honey-impregnated gauze and in 16.6% of cases treated withamniotic membrane (p < 0.001). In the 52 patients treated with honey, 91% ofthe wounds were rendered sterile within 7 days. In the 52 patients treated withsilver sulfadiazine, 7% showed control of infection within 7 days.The time taken for healing was significantly shorter with thehoney-treated group (p<0.001): of the wounds treated with honey 87% healedwithin 15 days compared with 10% of those treated with silver sulfadiazine.Better relief of pain, less exudation, less irritation of the wound, and alower incidence of hypertrophic scar and post-burn contracture were noted withthe honey treatment. The time taken for healing was significantly shorter withthe honey-treated group (p<0.001).Of the wounds treated with honey, 84% showed satisfactoryepithelialisation by the 7th day, 100% by the 21st day. In wounds treated withsilver sulfadiazine, epithelialisation occurred by the 7th day in 72% of thepatients and in 84% of patients by 21 days. Histological evidence of reparativeactivity was seen in 80% of wounds treated with the honey dressing by the 7thday, with minimal inflammation. No skin grafting was required for the woundstreated with honey, but four of the wounds treated with silver sulfadiazineconverted to deep and required skin grafts. Of the wounds treated with honey,100% healed within 15 days compared with 50% of the wounds treated with boiledpotato peel dressings. There was reported a transient stinging sensation andredness of the eye soon after putting honey in the eye, but never enough tostop the treatment in the 102 cases in a trial of honey for ophthalmologicaluse (55). However, in none of the many reports published on the clinical usageof honey on open wounds was the honey that was used sterilised, yet there areno reports of any type of infection resulting from the application of honey towounds. This objection can be overcome by the use of honey that has beentreated by gamma-irradiation, which kills clostridial spores in honey (60, 61)without loss of any of the
antibacterial activity (60).It also provides a supply of glucose for leucocytes, essential for the'respiratory burst' that produces hydrogen peroxide, the dominant component ofthe antibacterial activity of macrophages (64).The high glucose levels that the honey provides would be used by theinfecting bacteria in preference to amino acids (68) from the serum and deadcells, and thus would give rise to lactic acid instead of ammonia and theamines and sulphur compounds that are the cause of malodour in wounds.Honey gives a fast rate of tissue regeneration and suppression ofinflammation, oedema, exudation and malodour in wounds, as evidenced inclinical observations and the results of animal studies and clinical trials.Also it has been suggested that the decreased turgor resulting from theapplication of honey may increase oxygenation of tissues (7). The cleansingeffect of the osmotic flow and the chemical or enzymic debriding effect ofhoney makes surgical debridement unnecessary, thus saving the patient pain orthe risks associated with anaesthesia. In addition there are the savings in thecosts of surgery where debridement and skin grafting become unnecessary whenhoney is used. TOPThe help of the interloan librarians at the University of Waikato inobtaining copies of reports, and of Anna attler and Paola Galimberti intranslating papers is gratefully acknowledged.Early history of wound treatment. Clinical observations on the woundhealing properties of honey. Treatment of pressure sores. Recent advances inthe management of Fournier's gangrene: Preliminary observations. Accelerationof wound healing by topical application of honey. Speeding up the healing ofburns with honey. The use of honey in the treatment of infected wounds. Theantibacterial activity of honey. 1. The nature of the antibacterial activity.The antibacterial activity of honey. 2. Variation in the potency of theantibacterial activity. A comparison of the sensitivity of wound-infectingspecies of bacteria to the antibacterial activity of manuka honey and otherhoney. Sudanese bee honey in the treatment of suppurating wounds. The use ofhoney in the treatment of chilblains, non-specific ulcers, and small wounds.Honey - its role in medicine. 3. Effect of heat. Wound healing properties ofhoney. The antimicrobial effect of honey in the management of septic wounds. Aclinical study of the topical use of bee honey in the treatment of some occulardiseases. Food allergy to honey: Pollen or bee products? Characterisation ofallergenic proteins in honey by means of immunoblotting. The effect ofgamma-irradiation on the antibacterial activity of honey.