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)
