Honey as the New 'Silver' Dressing in Wound Care

By Sylvie Hampton, The Journal of Community Nursing (UK), November 2007, Volume 21, Issue 11

Silver is known to reduce bacteria in wounds and this aids healing in intractable wounds. However, the silver element within the dressing increases the cost of treatment and many Trusts are taking silver dressings off of their formularies. This has an implication for patients with wounds as the potential for infection could rise if prevention is not a consideration.

Honey has had a valued place in traditional medicine for centuries and has been used for reducing potential for clinical infection and for accelerating wound healing. Although honey has been used since ancient times some practitioners still hesitate to apply honey for treatment of wounds and some clinicians are under the impression that there is little or no evidence to support the use of honey as a wound dressing although positive findings on honey in wound care are widely reported.

Honey has been shown to give good results on a very wide range of types of wounds and it is therefore mystifying that there appears to be a lack of universal acceptance of honey as a wound dressing…

The antibacterial effects of honey

The antibacterial property of honey was first recognised in 1892 by van Ketel. Honey is a supersaturated sugar solution with a low water activity and high osmolarity which means that there is little water available to support the growth of bacteria and yeast. The high osmolarity is also considered to be a valuable tool in the treatment of established infections, because it prevents the growth of bacteria and encourages healing…

The action of some honey is linked to the production of hydrogen peroxide on dilution of the honey with wound exudate. Hydrogen peroxide is a well-known antimicrobial agent, initially hailed for its antibacterial and cleansing properties when it was first introduced into clinical practice. In more recent times it has lost favour because of inflammation and damage to tissue. However, the hydrogen peroxide concentration produced in honey activated by dilution is typically around 1 mmol/l, about 1000 times less than in the 3 per cent solution commonly used as an antiseptic. The harmful effects of hydrogen peroxide are further reduced because honey sequesters and inactivates the free iron which catalyses the formation of oxygen free radicals produced by hydrogen peroxide and its antioxidant components help to mop up oxygen free radicals…

Clinical observations suggest that honey holds significant promise particularly in the management of non-healing wounds and when applied topically on wounds will accelerate the healing processes. It is also known for enhancing wound contraction in fresh wounds which is one of the key features of wound healing. Research has also indicated that honey may possess antiinflammatory activity which stimulates immune responses within a wound and the ability to modulate production and quenching of free radicals may contribute to the ability of some honeys to help in resolving the state of inflammation typifying chronic wounds…

Conclusion

Honey certainly has an effect on healing and has the potential to reduce clinical infection in wounds. It is useful in debridement of wounds and in reducing the malodour that can occur when bacteria is present. Therefore, there is an argument for replacing silver dressings with the more cost effective treatment with honey.