Article

Clinical evaluation of honey-based products for lower extremity wounds in a home care setting

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Abstract

Aims: To evaluate the efficacy of commercially available honey-based products for the treatment of lower extremity wounds in a home care nursing setting. Methods: Twenty-two patients with lower extremity wounds (six male and 16 female, with an average age of 64 years), were retrospectively selected. Six patients had venous insufficiency, five had diabetes and the remaining patients had hypertension or rheumatoid arthritis as a major underlying aetiology. All the patients had non-healing wounds of at least four weeks' duration, in which they had been treated primarily with povidone iodine or fusidic acid. Fifty percent of the wounds were infected. All the wounds were treated with honey-based products, and only covered with a secondary dressing for protection or absorption of exudate. Results: Infected wounds were controlled within a few days.All the wounds progressed to healing without any adverse effects. Blood glucose levels remained unaffected and dressing changes were pain-free, with dressings being easy to apply. Conclusions: The results indicate that honey-based products are antibacterial, help to debride the wound and promote wound healing, and are safe and easy to use as well as being cost-effective. Conflict of interest: None.

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... Emerging evidence from clinical studies suggests that honey is at least as effective as conventional treatments in healing wounds, particularly in very refractory cases such as in diabetics, the elderly, and extensively burned patients [47,48], but more clinical data are necessary for robust statistical appraisal [49]. Here, we have demonstrated the potency of natural honey as an antimicrobial wound dressing, and that multiple effects arise from a variety of active compounds, which not only allows active honey to be uniquely broad in spectrum, but also reduces the potential for resistant microbial populations to evolve. ...
... Honey use has been successfully reported in various wound care scenarios from burns to surgical to malignant wounds (Kegels, 2011;Saikaly and Khachemoune, 2017). Diabetic ulcers have also been among wound types most commonly treated (Candeias and Cardoso, 2007;Mohamed et al, 2013). ...
... Honey use has been successfully reported in various wound care scenarios from burns to surgical to malignant wounds (Kegels, 2011;Saikaly and Khachemoune, 2017). Diabetic ulcers have also been among wound types most commonly treated (Candeias and Cardoso, 2007;Mohamed et al, 2013). ...
... Honey use has been successfully reported in various wound care scenarios from burns to surgical to malignant wounds (Kegels, 2011;Saikaly and Khachemoune, 2017). Diabetic ulcers have also been among wound types most commonly treated (Candeias and Cardoso, 2007;Mohamed et al, 2013). ...
... 66 The glycoproteins may also serve as a potential candidate for developing a novel antibacterial drug. 50 Thomas et al. 125 Surgihoney Surgihoney RO Ô wound gel Dryden et al. 126 Dryden et al. 127 ...
Article
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... Emerging evidence from clinical studies suggests that honey is at least as effective as conventional antimicrobial therapy in healing wounds, particularly in very refractory cases, such as in individuals with diabetes, the elderly, and extensively burned patients, 25,26 but further clinical studies are necessary for robust statistical appraisal. 27 To date, more than 80 different microbial species associated with wound infections have been shown to 14 mm (40%) and 34 mm (34%) respectively. ...
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There is renewed interest in the therapeutic use of honey, including use in the treatment of infected wounds and burn patients. In this study, we have assessed the antibacterial activity of Libyan floral Hannon honey on Escherichia coli and Staphylococcus aureus, both known to infect wounds. The effects of four concentrations (5%-30%) of honey were compared with that of four antibiotics (ampicillin, tetracycline, polymyxin, and ciprofloxacin) on the growth of these bacteria at early log, mid log, and late log phases. It has been shown that E. coli and S. aureus are to some degree susceptible during mid log phase compared with late log phase, demonstrated by their complete resistance to antibiotics. Chemostat culture was used to investigate the effect of honey on E. coli grown at a steady state with specific growth rates between 0.1 to 0.5 hour(-1). The rate of killing was distinctively clear during the two stages of growth monitored: there was a relatively moderate reduction at the slow growth phase (0.1 to 0.3 hour(-1)), while a dramatic reduction was obtained at the fast growth phase (0.3 to 0.5 hour(-1)), reaching a complete reduction at 0.5 hour(-1). These results complement data using the cup-cut technique. The antibacterial effect of honey was concentration and time dependent, the bactericidal effect was indeed observed at low concentrations, it demonstrates that the honey has more impact on slow growing bacteria than antibiotics have. We suggest that more reduction could be achieved at higher concentrations of honey. These results may have important clinical implications, such as for the management of wound and burn patients.
... Similar results were obtained in a recent retrospective study in which 22 patients with lower extremity ulcerations had delayed healing, in part attributed to application of povidone iodine or fusidic acid, and 50% of the wounds were infected. After treatment with honey-based products, all cases progressed to healing (Kegels, 2011).The use of honey may therefore have a place in VLU treatment (Jull, 2013). Antibiotics are not recommended because there is no evidence that the routine use of systemic antibiotics promotes VLU healing. ...
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Chronic leg ulcers are a common medical problem among elderly patients and have a dramatic impact on quality of life as a result of pain, disability, and social isolation. Regardless of their cause, chronic leg ulcers remain difficult to treat. In recent years, there has been increasing interest in the use of honey as a therapeutic agent. Objective: To evaluate the efficacy of honey-based dressings in the treatment of chronic leg ulcers. Methods: Ten patients with chronic (mean duration 3.3 years) leg ulcers who had received non-honey based treatments with no improvement were included in this study. A honey gel dressing was applied twice a week as the only treatment. Results: Seven patients experienced complete healing of their leg ulcers. The remaining three patients showed a significant reduction in wound size, which was achieved in a mean time of 101 days (range 28-174 days). Conclusion: Honey-based dressings appear to be an efficient and easy to use treatment for leg ulcers.
... In the current study, the use of sub-inhibitory concentrations of honey has enabled us to examine the nature of honey inhibition, however these concentrations are well below those that would be used in a clinical situation, where whole honey is generally applied and complete and irreversible inhibition would be expected. Emerging evidence from clinical studies suggests that honey is at least as effective as conventional treatments in healing wounds, particularly in very refractory cases such as in diabetics, the elderly, and extensively burned patients [47,48], but more clinical data are necessary for robust statistical appraisal [49]. Here, we have demonstrated the potency of natural honey as an antimicrobial wound dressing, and that multiple effects arise from a variety of active compounds, which not only allows active honey to be uniquely broad in spectrum, but also reduces the potential for resistant microbial populations to evolve. ...
Article
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Treatment of chronic wounds is becoming increasingly difficult due to antibiotic resistance. Complex natural products with antimicrobial activity, such as honey, are now under the spotlight as alternative treatments to antibiotics. Several studies have shown honey to have broad-spectrum antibacterial activity at concentrations present in honey dressings, and resistance to honey has not been attainable in the laboratory. However not all honeys are the same and few studies have used honey that is well defined both in geographic and chemical terms. Here we have used a range of concentrations of clover honey and a suite of manuka and kanuka honeys from known geographical locations, and for which the floral source and concentration of methylglyoxal and hydrogen peroxide potential were defined, to determine their effect on growth and cellular morphology of four bacteria: Bacillus subtilis, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. While the general trend in effectiveness of growth inhibition was manuka>manuka-kanuka blend>kanuka>clover, the honeys had varying and diverse effects on the growth and cellular morphology of each bacterium, and each organism had a unique response profile to these honeys. P. aeruginosa showed a markedly different pattern of growth inhibition to the other three organisms when treated with sub-inhibitory concentrations of honey, being equally sensitive to all honeys, including clover, and the least sensitive to honey overall. While hydrogen peroxide potential contributed to the antibacterial activity of the manuka and kanuka honeys, it was never essential for complete growth inhibition. Cell morphology analysis also showed a varied and diverse set of responses to the honeys that included cell length changes, cell lysis, and alterations to DNA appearance. These changes are likely to reflect the different regulatory circuits of the organisms that are activated by the stress of honey treatment.
Chapter
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