shura

Dr M. Subrahmanyam, Professor and Head, Department of Surgery, Dr Vaishampayan Memorial Medical College, Solapur 413 003, , Maharashtra, , India.

University Department of Surgery, University Teaching Hospital, Calabar, Nigeria.

Fifty-nine patients with wounds and ulcers most of which (80 per cent) had failed to heal with conventional treatment were treated with unprocessed honey. Fifty-eight cases showed remarkable improvement following topical application of honey. One case, later diagnosed as Buruli ulcer, failed to respond. Wounds that were sterile at the outset, remained sterile until healed, while infected wounds and ulcer became sterile within 1 week of topical application of honey. Honey debrided wounds rapidly, replacing sloughs with granulation tissue. It also promoted rapid epithelialization, and absorption of oedema from around the ulcer margins.

WOUND CARE

Journal of Wound, Ostomy & Continence Nursing. 29(6):295-300, November 2002.
Lusby, P. E. BappSci (Med & App Biotech); Coombes, A. B Med Lab Sci; Wilkinson, J. M. BSc, PhD, GradDip FET

Abstract:
Although honey has been used as a traditional remedy for burns and wounds, the potential for its inclusion in mainstream medical care is not well recognized. Many studies have demonstrated that honey has antibacterial activity in vitro, and a small number of clinical case studies have shown that application of honey to severely infected cutaneous wounds is capable of clearing infection from the wound and improving tissue healing. The physicochemical properties (eg, osmotic effects and pH) of honey also aid in its antibacterial actions. Research has also indicated that honey may possess antiinflammatory activity and stimulate immune responses within a wound. The overall effect is to reduce infection and to enhance wound healing in burns, ulcers, and other cutaneous wounds. It is also known that honeys derived from particular floral sources in Australia and New Zealand (Leptospermum spp) have enhanced antibacterial activity, and these honeys have been approved for marketing as therapeutic honeys (Medihoney and Active Manuka honey). This review outlines what is known about the medical properties of honey and indicates the potential for honey to be incorporated into the management of a large number of wound types.

Journal of the Royal Society of Medicine Volume 82 July 1989

Honey has had a valued place in traditional medicine
for centuries. The prescription for a standard wound
salve discovered in the Smith papyrus (an Egyptian
text dating from between 2600 and 2200 BC) calls for
a mixture of mrht (grease), byt (honey) and ftt
(lint/fibre) as transliterated from hieroglyphic symbols”
2. The ancient Egyptians, Assyrians, Chinese,
Greeks and Romans employed honey for wounds and
diseases of the gut. Honey was the most popular
Egyptian drug being mentioned 500 times in 900
remedies’. Whilst Hippocrates (3rd and 4th centuries
BC) made little use of drugs in treatment he
prescribed a simple diet, favouring honey given as
oxymel (vinegar and honey) for pain, hydromel
(water and honey) for ‘thirst’3′4, and a mixture of
honey, water and various medicinal substances
for acute fevers5. During the Biblical era honey
received religious endorsement by both Christianity
and Islam. When the Children of Israel were in
Egypt or were journeying through the desert, the
promise was made that their destination was to be
‘a land flowing with milk and honey’6. The holy
Qur’an vividly illustrates the potential therapeutic
value of honey7′8.
Thy Lord has inspired the Bees,
to build their hives in hills,
on trees and in man’s habitations,
From within their bodies comes
a drink of varying colours,
wherein is healing for mankind,
Verily in this is a Sign,
for those who give thought.
Although a vast number of papers and articles have
been published on the subject, most have concentrated
on the biochemical analysis and food and non-food
commercial uses9″10. In the past, scientific opinions
on honey’s nutritive and medical uses have differed
and clashed with folklore. Controversies within the
scientific community5 have re-kindled interest in the
therapeutic uses of honey in modern medicine.
Recently, scientific support has emerged with a
proliferation in publications on the successful
therapeutic use of honey in several general medical
and surgical conditions.
The antibacterial”l’l3 and antifungal14 properties
of honey have been well documented, with growth of
organisms such as Staphylococcus aureus,
Enteropathogens and Candida albicans inhibited in
undiluted honey. Jeddar et al.12 have shown that
honey at a concentration of 40% was bactericidal to
various gram-negative and gram-positive bacteria. In
particular, Salmonella shigella, enteropathogenic
Escherichia coli and Vibrio cholera - all of which are
major causes of morbidity and mortality worldwide.
Used at concentrations ofbetween 30% to 50% honey

was found to be superior to cephaloridine, ampicillin,
gentamycin, nitrofurantoin, nalidixic acid and cotrimoxazole
in inhibiting growth of nine types of
pathogenic organisms isolated from the urine samples
of 149 patients with confirmed urinary tract
infection13. The mechanism of the antibacterial effect
of honey remains speculative. Shrinkage disruption
of the bacterial cell wall due to the osmotic effect, low
pH, and the presence of bactericidal substances
collectively called inhibine may contribute.
Honey has been of proven value in treating infected
surgical wounds, burns and decubitus ulcers’5-’8.
Cavanagh et al.” successfully used local application
ofhoney in the postoperative management ofpatients
who had undergone radical vulvectomy for vulval
carcinoma. Wound healing was accelerated and less
bacterial colonization noted by local application of
honey in patients who developed postoperative wound
breakdown. A recent study from West Africa19 showed
that skin grafting, surgical debridement and even
amputation were avoided when local application of
honey to wounds promoted healing whereas conventional
treatment had failed. These observations have
been borne out by an animal model in which pure
commercially available honey applied on 12 mice
healed wounds significantly faster than those of
controls2O. Honey is extremely viscous2l, hygroscopic,
contains enzymes such as catalase’0 and together
with its antibiotic properties, this enables it to absorb
water from surrounding oedematous tissue, clean the
wound and protect it from further infection. Slough
and necrotic tissue is gradually separated as a
consequence, leaving healthy granulation tissue
behind.
A clinical study involving 169 infants and children
with gasteroenteritis demonstrated that honey, given
with oral rehydration fluid, shortens the duration of
bacterial diarrhoea22. It was concluded that honey
can safely be used as a substitute for glucose in
solution with electrolytes and is just as efficient
as glucose in promoting sodium and water absorption
from the gut. Reports of supplementation of infant
diets with unprocessed honey contaminated with
spores of Clostridium botulinum resulting in botulism
has put honey’s traditional role in infant feeding
rather severely into disrepute23.
Although honey has been used for commercial and
domestic uses for thousands of years, much of the
literature is only descriptive. Further evaluation and
application ofthe healing properties of honey in other
clinical and laboratory situations is warranted. For
example, use of it could be made in the field of leprosy.
The foul smelling, chronic ulcers contribute to the
social degradation and isolation of the patient. Could
these be treated with this simple, acceptable and
readily available remedy? Deoxyfructose serotonin,
a substance derived from coffee-wax, has an anti-
Mycobacterium leprae action and has been shown in
preliminary studies to be of benefit in patients with