Honey has been used as a topical wound treatment since antiquity. There is renewed interest in its use in wound care, especially chronic wounds that are resistant to standard care. Its efficacy needs to be confirmed in adequately powered clinical trials.


Antimicrobial action of honey:

(1) high sugar concentration (affecting oncotic pressure)

(2) low free-water activity

(3) low pH

(4) variable hydrogen peroxide release

(5) various chemicals related to nectar source (bees in New Zealand feeding on the manuka tree are the source for Manuka honey)


Medical-grade honey is a processed product that is free of contaminants. It is filtered and has undergone gamma irradiation.


Grocery or wild honey may contain bacteria, anaerobic spores (Clostridium botulinum), yeast and fungi.


It may be applied directly to the wound or included in a dressing.


Advantages of honey:

(1) active against antibiotic-resistant organisms.

(2) reduces soft tissue chemical injury

(3) reduces wound malodor

(4) may stimulate an immune response

(5) may encourage autolytic debridement of devitalized tissues


Complications of honey may include:

(1) maceration of adjacent skin

(2) allergic reaction

(3) hyperglycemia in diabetes

(4) possible infection (if a non-medicinal honey used)

(5) pain (associated with low pH or allergic reaction)


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