125 research outputs found
The evidence supporting the use of honey as a wound dressing
No full textSome clinicians are under the impression that there is little or no evidence to support the use of honey as a wound dressing. This impression is reinforced by it being concluded in systematic reviews that the evidence is not of a high standard. But likewise the evidence for modern wound dressing products is of not of a high standard. For evidence-based medicine to be practised in wound care, when deciding which product to use to dress a wound it is necessary to compare the evidence that does exist, rather than be influenced by advertising and other forms of sales promotion. To allow sound decisions to be made, this review has covered the various reports that have been published on the clinical usage of honey. Positive findings on honey in wound care have been reported from 17 randomised controlled trials involving a total of 1965 participants, and 5 clinical trials of other forms involving 97 participants treated with honey. The effectiveness of honey in assisting wound healing has also been demonstrated in 16 trials on a total of 533 wounds on experimental animals. There is also a large amount of evidence in the form of case studies that have been reported. Ten publications have reported on multiple cases, totalling 276 cases. There are also 35 reports of single cases. These various reports provide a large body of evidence to support honey having the beneficial actions of clearing and preventing wound infection, rapidly debriding wounds, suppressing inflammation and thus decreasing oedema, wound exudate and hypertophic scarring, and stimulating the growth of granulation tissue and epithelialisation. It has been shown to give good results on a very wide range of types of wound. Clinicians should look for the clinical evidence that exists to support the use of other wound care products to compare with the evidence that exists for honey
The evidence and the rationale for the use of honey as wound dressing
No full textAlthough there are now several brands and types of honey wound-care products available as registered medical devices, there is little promotional advertising of honey products for wound care. The misconception that there is no evidence to support the use of honey, which seems to be quite common, may be due to this lack of advertising, and to the systematic reviews that have been published on honey concluding that the evidence is of low quality and/or there is a need for more evidence. However, the same lack of high-quality evidence exists with all the other options that clinicians have for dressing wounds. This places practitioners in a quandary. When clinical evidence of the highest level is not available, then decisions on modes of treatment need to be based on whatever evidence there is available. This review outlines the 16 randomised controlled trials (RCTs) of honey in wound care published since Molan reviewed the previous 17 in 2006, which bring the total of participants in the trials up from 1,965 to 3,556 and broadens the range of types of wounds on which trials with honey have been conducted. Another important factor influencing the choice by clinicians of which product to use on a wound is scientific rationale. This review covers the evidence and explanation of mode of action for various bioactivities in honey which aid wound healing: a very broad-spectrum antimicrobial activity that is effective on antibiotic-resistant strains; activation of autolytic debridement; anti-inflammatory activity; antioxidant activity; stimulation of growth of cells for tissue repair; and an osmotic action. The need for standardisation of these bioactivities is discussed
Using honey in wound care
No full textHoney is primarily a herbal product with some modifications that are made by the bees that process the nectar or sap collected from the plants to store as honey. The types of phytochemicals present in a honey depend on the plant source of the honey. The hydrogen peroxide that is formed in honey by an enzyme the bees add, and sometimes also particular phytochemicals from the nectar or sap, give honey antibacterial activity that is sufficient to be effective in clearing infection from wounds. The phytochemicals also give honey its antioxidant activity which is also important in wound care, acting to decrease inflammation. Honey has been used in wound care since ancient times, but was displaced from use by the advent of antibiotics. With the widespread resistance to antibiotics developing in bacteria, it is now being 'rediscovered', and in many cases is proving to give better results than modern wound-care products. It has the advantage of providing moist healing conditions without the risk of bacterial growth, preventing adhesion of dressings to wound tissues, giving rapid removal of pus, dead tissue and debris from wounds, decreasing inflammation and thus decreasing swelling, pain and exudation of serum and preventing scarring, and speeding up the growth of tissues to repair wounds
Re-introducing honey in the management of wounds and ulcers - theory and practice
No full textDressing wounds with honey was standard practice in past times but went out of fashion when antibiotics came into use. There has been a renaissance in its usage now that antibiotic-resistant bacteria have become a widespread clinical problem, and laboratory studies and clinical trials have shown that it is a very effective broad-spectrum antibacterial agent with no adverse effects on wound tissues. Modern studies have also shown that as well as having an antibacterial action, honey has several other activities that are beneficial to the wound healing process. It gives rapid autolytic debridement and deodorising of wounds, and stimulates the growth of wound tissues thus hastening healing and starting the healing process in dormant wounds. Its anti-inflammatory activity rapidly reduces pain, edema and exudate and minimises hypertrophic scarring. It also provides a moist healing environment for wound tissues with no risk of maceration of surrounding skin, and completely prevents adherence of dressings to the wound bed so that there is no pain and no tissue damage when dressings are changed. By use of appropriate dressing practices any problems of messiness and difficulty of handling can be easily overcome
Honey as an antiviral agent against respiratory syncytial virus
No full textRespiratory syncytial virus is the most frequent cause of hospitalization for viral respiratory infections in infants and young children worldwide. It also severely affects immunocompromised adults and the elderly, however, despite decades of efforts, there is no proven effective treatment for RSV infection and attempts at vaccine development have been hampered by several major obstacles. A large amount of research has established the potent antibacterial activity of honey, but its activity against viral species has been the subject of only a small number of studies. These were with viruses which cause localised infections in which honey could be used topically. Recent studies demonstrating the safety of intrapulmonary administration of honey in sheep and humans raised the possibility of using honey to treat respiratory infections. The aim of this study, therefore, was to extend the knowledge obtained from previous studies of honey’s antiviral activity to its action against RSV. A variety of tests using cell culture were developed to evaluate the susceptibility of RSV to honey. Each test monitored and scored the development of morphological changes to the cells caused by RSV infection to determine whether the honey had any inhibitory effect on these changes. These included tests for: inhibition, where honey was used to treat infected cells; protection, in which the cells were treated with honey prior to infection; neutralisation, in which the virus was directly exposed to the honey for a defined period before being used to inoculate the cells. Pre-treatment of the cells had no effect on the consequent development of cytopathic effect, while the inhibition and neutralisation experiments showed a significant inhibitory effect on the progression of infection, suggesting a direct effect on the virus rather than on the cells, however, further studies are required to confirm this. A wide range of honey types were tested for their inhibitory and neutralising capabilities against RSV and the results suggested that the antiviral activity may be characteristic of more than one type of honey. The activity observed did vary, however, with some types of honey causing greater inhibition of RSV than others. Enzyme-linked immunosorbent assays were also used to quantitatively measure the number of viral antigens in honey-treated and untreated cells. The results confirmed that treatment with honey had caused inhibition of viral replication, there being very little virus detected in honey-treated cells compared with untreated cells infected with RSV. Experiments using quantitative PCR also demonstrated the inhibitory effect of honey on RSV at the transcription level, with significant differences in the mRNA copy numbers of two out of the three viral genes examined. Attempts at isolating the antiviral component in honey demonstrated that the sugar was not responsible for the inhibition of RSV, but that methylglyoxal may play a part in the greater potency of Manuka honeys against RSV. It is concluded from the findings in this study that honey may possibly be an effective antiviral treatment for the therapy of respiratory viral infections, and provides justification for future in vitro studies and clinical trials
The Study of the Antioxidant Activity of Phenolic Components of Manuka Honey
No full textThe phenolic compounds of honey have been known to pose significantly antioxidant activity, including iron-binding and free radical scavenging activity. Manuka honey has been widely used in wound treatment and the antioxidant activity of manuka honey is important in that. However, the antioxidant activity of phenolic compounds of manuka honey has been studied in a few of cases. The aim of this study was to identify the molecular structure of phenolic compounds of manuka honey mainly responsible for each type of antioxidant activity (iron-binding and free radical scavenging activity). The measurement of iron-binding type of activity was based on the inhibition of the Fenton reaction using the β-carotene-linoleic acid model system and the measurement of free radical scavenging activity was based on ABTS system. The phenolic extracts of manuka honey obtained off XAD column was run through Sephadex G-25 column. The elution was pooled to form fractions for assaying of antioxidant activity, so that the fractions with highest antioxidant activity can be detected. The fractions with highest antioxidant activity, including iron-binding and free radical scavenging activity, were re-run through Sephadex G-25 again, and the resulting fractions were assayed. After repeating fourth running through Sephadex G-25 column, 5 pools with highest antioxidant activity were obtained. The elution volumes of these 5 pools were mainly from 105.6 – 115.2 ml, indicating that this volume range had most of the antioxidant activity for phenolic extracts of manuka honey. Five pools were further separated by Superdex Peptide column on the FPLC system. The results showed that each pool was separated to have several main peaks. Each peak obtained from chromatography of all five pools was taken for activity assay. The peak with highest iron-binding activity was selected for structure identification by UV and mass spectra methods. The conclusion was made that the phenolic compound responsible for iron-binding type of antioxidant activity could be the molecule with molecular weight of 458
Clinical usage of honey as a wound dressing: An update
No full textHoney is an ancient treatment that is increasingly earning its place in modern wound care. Evidence suggests it compares with other dressings in terms of its antibacterial properties, ease of use and ability to promote a moist environmen
The true relationship of NPA and MG levels
No full textThere has been up until now a major misunderstanding of the relationship between different levels of antibacterial activity in manuka honey. It has always been assumed that for example, a honey with a non-peroxide antibacterial activity (NPA) of 20 is twice as potent as one with a rating of NPA 10, but that is in fact not correct
The antibacterial activity of honey: 2. Variation in the potency of the antibacterial activity
No full textHoney is gaining acceptance by the medical profession for use as an antibacterial agent for the treatment of ulcers and bed sores, and other surface infections resulting from burns and wounds. In many cases it is being used with success on infections not responding to standard antibiotic and antiseptic therapy. Its effectiveness in rapidly clearing up infection and promoting healing is not surprising in light of the large number of research findings on its antibacterial activity, covered in Part 1 of this review
Why honey is effective as a medicine. 2. The scientific explanation of its effects
No full textThe effectiveness of honey as a therapeutic agent has been unequivocally demonstrated in the literature reviewed in Part 1 of this article published in 1999, but the biochemical explanation of these effects is more hypothetical. However, a rational explanation can be seen when one looks at the scientific literature outside that on honey. Some of the components of honey are substances known to have physiological actions that would explain many of its therapeutic effects. In addition, research on honey has shown directly that it has physiological actions that would give therapeutic effects
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