An ancient remedy for the treatment of infected wounds, honey has recently regained its reputation in the medical field – particularly where conventional modern therapeutic agents are failing. There are now many published reports describing the effectiveness of honey in rapidly clearing infection from wounds; there is also much evidence suggesting that honey actively promotes healing.
The current resurgence of antibiotic-resistant microbial species has led to a re-evaluation of the therapeutic use of ancient remedies such as honey.
Medicinal uses for honey go back 5,000 years, to the Egyptians and the Greeks. Honey was used to treat infected wounds 2,000 years before bacteria were discovered to be the cause of infection. In about 50 AD, Dioscorides described honey as being "good for all rotten and hollow ulcers." The antibacterial property of honey was first recognized in 1892 by van Ketel.
Honey is produced from many different floral sources and its antibacterial activity depends on origin and processing. Honey selected for clinical use should be evaluated on the basis of antibacterial activity levels determined by laboratory testing.
Honey produced as a food often is not well filtered, and may contain various particles. In addition, although honey does not allow vegetative bacteria to survive, it does contain viable spores, including clostridia. Various brands of honey with standardized antibacterial activity, processed as a medical product and sterilized by gamma-irradiation (to kill clostridial spores) are available commercially.
Manuka honey, from New Zealand, is a particularly potent type.
Honey is composed of sugars such as glucose and fructose, and minerals such as magnesium, potassium, calcium, sodium chlorine, sulfur, iron and phosphate. It contains vitamins B1, B2, C, B6, B5 and B3 according to the specific qualities of the source nectar and pollen. Copper, iodine, and zinc also exist in it in small quantities, as well as several types of hormones.
Many types of bacteria can't survive in honey, so wounds heal, swelling eases, and tissue can grow back.
The antibacterial properties of honey include the release of low levels of hydrogen peroxide. Some honeys have an additional phytochemical antibacterial component. When honey comes into contact with body moisture, the glucose oxidase enzyme introduced to the honey by the bees slowly releases the antiseptic hydrogen peroxide at a sufficient level to be effective against bacteria but not tissue-damaging.
Not only is honey anti-bacterial, it also draws body fluids and nutrients to the area and so assists cell growth and prevents a scar forming by drying out of the wound.
Honey has been reported effective against over 60 species of bacteria including aerobes and anaerobes, gram-positives and gram-negatives. An antifungal action has also been observed for some yeasts and species of Aspergillus and Penicillium, as well as all the common dermatophytes. [Molan PC. The Antibacterial Activity of Honey. Bee World 1992; 73(1): pp5-28]
The osmotic action of the honey draws out and provides a film of liquid between the tissues and the dressing, allowing the dressing to be removed painlessly, without tearing of the re-growing cells.
Experiments conducted on honey show that its antibacterial properties increase two-fold when diluted with water.
Honey can do what an increasing number of modern antibiotics cannot: it can stop drug-resistant superbugs such as MRSA.
Honey is used in infected wounds and some recommend its prophylactic use on the wounds of patients susceptible to MRSA and other antibiotic-resistant strains of bacteria.
It has been shown that wounds infected with Staphylococcus aureus are quickly rendered sterile by honey. [Efem SE. Clinical observations on the wound healing properties of honey. Br J Surg 1988; 75(7): pp679-81]
Honey has been used to treat infections in a wide variety of wound types. These include burns, leg ulcers, diabetic foot ulcers, pressure ulcers, unhealed graft donor sites, abscesses, boils, pilonidal cysts, infected wounds from lower limb surgery, necrotizing fasciitis, and neonatal postoperative wound infection. In many of these and other cases, honey has been used to heal wounds not responding to treatment with conventional antibiotics and antiseptics.
There are reports in medical journals of large bed sores, otherwise needing skin grafts, that have healed without scarring after honey treatment.
Although there are no decisive studies, many believe that, over time, exposure to small amounts of pollen from your local area lessens seasonal allergies. It is the same principle behind allergy shots.
A Penn State study has found that a dose of buckwheat honey before bedtime relieves children's coughs better than medications.
In treating diarrhea, honey promotes the rehydration of the body and more quickly clears up the diarrhea and any vomiting and stomach upsets.
Honey is a good source of antioxidants, which play a big role in the prevention of cancer and heart disease.
Substantial amounts of honey need to be applied to a wound to achieve adequate potency. Although it may be very viscous at room temperature, honey becomes very fluid at body temperature and even more fluid if diluted with proportionally small volumes of wound exudate. It is therefore very important that sufficient honey is applied to a wound and that it is kept in place if a good therapeutic effect is to be obtained.
The amount of honey required on the wound depends on the amount of fluid exuding from the wound (this dilutes the honey.) The frequency of dressing changes required will depend on how rapidly the honey is being diluted by exudate. If there is no exudate, dressings need to be changed twice-weekly to maintain a 'reservoir' of antibacterial components as they diffuse into the wound tissues.
The honey should be applied to an absorbent dressing prior to application, not directly to the wound because it tends to run off before the dressing is able to hold it in place. Warm the honey to body temperature and/or add 1 part water to 20 parts honey to make the honey more fluid and absorbable.
Any depressions or cavities in the wound need to be filled with honey in addition to using a honey-impregnated dressing topically. This ensures that the honey diffuses into the wound tissues.
For 'cavity wounds' (deeper wounds) that are not exuding heavily, a 'blister' of honey can be held on a wound using an adhesive film dressing.
For wounds that exude significantly, a secondary dressing may be needed to contain seepage of diluted honey from the primary dressing. A watertight dressing such as polyurethane film is best, as an absorbent secondary dressing tends to draw the honey away from the wound surface.
Honey can safely be introduced into cavities and sinuses. It is water-soluble and easily rinsed out, and any residues are bio-degradable. For sinuses with small openings, a catheter on a syringe filled with honey is an effective applicator.
Since infection may lie in the tissues underlying the wound margins, honey dressings need to extend beyond the inflamed area surrounding a wound.
Allergic reactions to honey are rare and have been attributed in some cases to a reaction to a specific pollen in the honey.
And honey should not be given to young children, especially those under 12 months, because of the risk of botulism.
Raw honey rubbed on the infected areas before bedtime and left overnight has also been found to be effective. Cover the feet with an old sock.
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