Debridement of wounds with honey

Abstract

Honey has been used as a debriding agent since ancient times. Its debriding properties have been rediscovered in more recent times, with various case reports published in the latter decades of the 20th century describing its effectiveness in cleaning up wounds. More recently its effectiveness has been compared with that of modern debriding agents, and honey has been found to work more rapidly than all except larval therapy. A randomised controlled trial demonstrated significantly better debriding with honey than with hydrogel. Other trials have shown that honey is a good alternative to surgical debridement for the treatment of necrotising fasciitis in the genital region. Seven case series and ten single case studies have also been published in which the effectiveness of honey in debriding wounds was reported. A prophylactic action of honey has also been reported, where in a randomised controlled trials comparing honey with silver sulfadiazine for the treatment of burns there was no eschar formed with honey but there was eschar formed in the cases treated with silver sulfadiazine. A similar finding has been reported in an animal model, where adjacent experimental wounds were kept clean with honey-soaked gauze but formed thick dense scabs where treated with saline-soaked gauze. The mechanism of action of honey is as yet unknown, but appears to be by way of stimulating autolytic debridement. Additional advantages using honey rather than other moist debridement are that its antibacterial action prevents bacterial growth from being encouraged, and its osmolarity prevents maceration of periwound skin.