The antimicrobial properties of honey prevent microbial growth in themoist healing environment created. The stimulation of
healing may also be dueto the acidity of honey. In 1989 an editorial in the Journal of the Royal Society of Medicineexpressed the opinion: "The therapeutic potential of uncontaminated, purehoney is grossly underutilized. Mostly this was in reference to reports of the use of honey as a wounddressing. Because of the increasing interest in the use of alternativetherapies, especially as the development of antibiotic resistance in bacteriais becoming a major problem. and because of the increase in reported usage ofhoney as a wound dressing in recent times, it was considered timely to reviewthe clinical and experimental findings that have been published on thissubject. In many of the reports the effectiveness of honey as a dressing oninfected wounds is attributed in part to its antibacterial properties . However,it is noted here for the interest of the reader that honeys with median levelsof antibacterial activity have been found to completely inhibit the majorwound-infecting species of bacteria at concentrations of 1.8% - 11% (v/v) . anda collection of strains of strains of MRSA at concentrations of 1% - 4% (v/v) .One cleaned the wounds with gauze. In many of the reports the honey isspread on the wound then covered with a dry dressing, mostly gauze.The quantityof honey used varies: one reported using a thin smear of honey (but withrelatively poor outcomes); two reported using a thin layer honey (but this wasapplied 2 - 3 times daily); most just refer to the honey being spread or pouredover the wound, others report using a thick layer of honey. soaking the woundgenerously with honey, pouring honey into the wound to three-quarters fill, andapplying 15-30 ml of honey to ulcers. Others have applied the honey to thedressing then placed it on the wound: either the honey was spread on gauze orthe gauze was soaked in honeyor "honey pads" were used. Others havepacked cavities of wound directly with honey and then covered the wound. It hasalso been reported to promote epithelialisation of the wound. Improvement ofnutrition of wounds has been observed. also increased blood flow has been notedin wounds, and free flow of lymph. Several authors have commented on the rapidity of healing seen withhoney dressings. Blomfield is of the opinion that honey promotes healing ofulcers and burns better than any other local application used before.
Granulation, scar formation, and complete healing occurred faster with honeythan with nitrofurazone and in the control. Histomorphological
examination ofbiopsy samples revealed more marked acute inflammatory changes in the wounds inthe control and with nitrofurazone than with honey, and less proliferation offibroblasts and angioblasts. Clinical examination of the wounds andhistomorphological examination of biopsy samples showed that honey gave thefastest rate of healing compared with the other treatments, the leastinflammatory reaction, the most rapid fibroblastic and angioblastic activity inthe wounds, the fastest laying down of fibrous connective tissue, and thefastest epithelialisation. Histological examination showed that the thicknessof granulation tissue and the distance of epithelialisation from the edge ofthe wound were significantly greater, and the area of the wound significantlysmaller, in those treated with honey (p<0.001). A statistically significantincrease in the rate of healing was seen with the treatment with floral honeycompared with the saline control, this being greater with oral than withtopical administration. The infiltration of granulation tissue with chronicinflammatory cells was greatest in the wounds treated with honey from bees fedon sugar, less in those treated topically with floral honey, and least in thosetreated orally with floral honey. The rats were treated with topicalapplication of honey to the wound, oral administration of honey, orintraperitoneal administration of honey, or untreated as a control. Both thequantity of collagen synthesised and the degree of cross-linking of thecollagen in the granulation tissue were found to have increased significantlycompared with the untreated control as a result of treatment with honey(p<0.001). The content of DNA, protein, collagen, hexosamine and uronicacid, and the tensile strength, stress-strain behaviour, rate of contraction,and the rate of epithelialisation were found to have increased significantly asa result of treatment with honey (p<0.05 - <0.001). The outcomes of the58 other cases were reported as "showed remarkabl e improvement followingtopical application of honey.The wounds were of mixed aetiology: surgical, accidental, infective,trophic, and burns; the average size of the wounds was 57 cm2. The number ofmicroorganism isolates from the wounds dropped from 48 to 14 after two weeks oftreatment. Seven of the patients had necrotic tissue excised after treatmentwith honey, and three of these had skin grafts.