Revisiting the Use of Honey for Treating Chronic Wounds

PRIMARY CARE
Revisiting the Use of Honey for
Treating Chronic Wounds
Ann Reese, MSN, RN, CWOCN, GNP; Deborah Willoughby, PhD, RN, ACNS;
Stephanie C. Davis, PhD, RN, FNP- BC; Toni Silver, RN, APN-BC, CWCN; and
Tad Venn, MD
Honey was used as a wound dressing in ancient times but was
replaced by antiseptics and antibiotics in the 19th and 20th
centuries, respectively. Hone}' has recently regained favor—
with scientific evidence to back it up—as a treatment for
chronic wounds. Honey is being used lo manage venous,
al, diabetic, and pressure ulcers and burns, panicukjjffpThose
infected b}> methicillin-resistant StaphylococfigJ^iureus 0r
vancomycin-resistant enLero&gd.'&to^^mJstiave performed
an evidence-based revi0tajOjUngS^^^^ical-grade hone}'for
chronic wounds, andMiffojMH^BHRions of these research
findings for nurse pi
One percent to 2% of the inhabitants
of developed countries
have a chronic wound In the
United States, more than 6 million
chronic wounds are treated each
year, at a cost of >520 billion."
Wounds are considered chronic if
Lhey do not heal within 3 months/
Depending on the cause, chronic
wounds may be classified into one
of four categories: venous ulcers,
arterial ulcers, diabetic ulcers, and
pressure ulcers (Table i). Venous
ulcers, which occur as a result of
chronic venous insufficiency,
account for about one-half of
chronic lower-extremity wounds,
and affect 0.14%-2% of the population."
Arterial ulcers result from
poor arterial perfusion and comprise
~25% of leg ulcers.' Diabetic
ulcers occur in patients with diabetes
mellitus (DM) and art due to
impaired circulation and sensation
in the lower extremities. The prevalence
of foot ulcers in patients with
DM is 12.7%." This patient group
also has a lifetime risk of 15%-
25% of developing a lower-extremity
ulcer, making DM the wading
cause of non-traumatic amputations
in the United States. Pressure
ulcers are caused by unrelieved pressure
or shear, which causes damage
to the tissue: the prevalence of pressure
ulcers rises with age.'
•'"•""i'.'.'B' • 27

PRIMARY CARE
Treatment of chronic wounds
poses a challenge. A favorable outcome,
represented by a healing
wound, depends on maintaining a
moist wound bed, removing necrotic
tissue without harming healthy
tissue, and preventing and treating
infection. Some readers may be surprised
to learn that the application
of honey to chronic wounds has
been shown to facilitate a healing
wound environment.'•'
The use of honey as a treatment
for wounds dates back to the time
of the ancient Egyptians and
Creeks." Therapeutic use of honey
was abandoned in the latter half of
the 19th century and early 20th
century following the introduction
of antiseptics and then antibiotics.
However, the development of
multi-drug-resistant bacteria and
the rising incidence of chronic
wounds have led to a reconsideration
of the use of honey in treating
wounds.: 1
The US food and Orug Administration
has approved two
therapeutic honeys for use in this
country. Medihoney Antibacterial
Medical Honey and Active Manuka
Honey. Both honeys are derived
from the manuka bush in New-
Zealand (also known as Leptospermum
scoparium). These honeys
have been sterilized, but not inactivated,
through gamma irradiation,
which destroys Clostridium spores.
The honeys contain a unique manuka
factor, which gives them additional
antibacterial activity and
distinguishes them as
therapeutic
honeys. These honeys are safe, easy
to use, and cost effective, and have
emerged as wound treatments that
can achieve a variety of therapeutic
outcomes.••' Of note, culinary
honey purchased in a supermarket
is not medical grade and not suitable
for this use.
Some NTs may be unaware of
recent research supporting the use
of honey in wound care."
Although evidence suggests that
honey is beneficial in treating
acute wounds, this integrative
review examines the use of honey
as a treatment for chronic wounds,
identifies indications for the use of
honey in this regard, describes the
application procedure, and discusses
parameters that must
be
monitored as indicators of treatment
effectiveness.
Honey-making Pnxess
Bees collect nectar from flowering
plants and then transport the nectar
to worker bees in a hive,
Hnzymes in the worker bees' stomachs,
two of which are important
to wound healing, break down the
nectar so that it is both more
digestible for the bees and less like-
!v to be attacked bv bacteria while
stored in the hive. The first
enzyme, glucose oxidase, converts
glucose to gluconolactone, which
yields gluconic acid and hydrogen
peroxide. The second enzyme, catalase,
which is active in l. scoparium,
helps manage biobimlen (ie, the
amount of bacteria or. a wound
surface before it is sterilized) in
wound fluid, tissue, blood, and
other body fluids. Bees then
spread the nectar throughout the
honeycombs, where some of the
water evaporates from it, resulting
in honey.
Therapeutic Effects of Honey
Honey affects wound healing
through five modes of action: (1)
antimicrobial properties, (2) antiinflammatory
properties, (3) promotion
of wound debridement
with eschar or slough, (4)
provision
of a moist wound environment,
and (5) reduction of wound
malodor.'' Although the mechanisms
by which honey exerts its
therapeutic effects are not well
understood, researchers have
shown that it exerts antimicrobial
effects against even antibiotic-resistant
bacteria.'
Honey, even when diluted to a
5% concentration, has been shown
to be effective against clinical isolates
of methicillin-resistant
Staphylococcus aureus (MRSA), S
I TABLE 1
TYPES OF CHRONIC WOUNDS
Type
Venous ulcers
Arterial ulcers
Diabetic ulcers
Pressure ulcers
Cause
Chronic venous insufficiency
Poor arterial perfusion
Impaired circulation and
sensation in lower extremities
Unrelieved pressure or shear
Comment
Account for about one-naif of chronic lower-extremity wounds; affect 0.14%-2% of
the population
Comprise -25% of leg ulcers; may not heal as well with honey therapy
12.7% of patients with DM have foot ulcers; lifetime risk of developing a lowerextremity
ulcer omong patients with DM Is 15%-25%; leading cause of non-traumatic
amputations in the United States
Prevalence rises with age

aureus, vancomycin-sensitive enterococci
(VSE), vancomycin-resistani
enterococci (VRE), Pseudomcmas
aeruginosa, beta-hemolytic streptococci,
Alcaligenes faecalis, Cilrobacter
freundii, Escherichia colt, kmerobacter
aerogenes, Klebsiella pneumoniae,
Mycobacterium phlei, Salmonella
California, Salmonella enteriiidis,
Salmonella typhimurium, Shigella
sonnei, Staphylococcus epidermidis,
Staphylococcus capitis, Staphylococcus
haemolyticus, Staphylococcus simulans,
and Staphylococcus warneri.'"1
-"• To date, honey has not been
shown to inhibit the growth of
Serratia marcescens or Candida albicans,
or to inhibit the growth of
Pseudomonas aeruginosa in patients
with cystic fibrosis.14
Several properties of honey are
thought to play a role in its antimicrobial
activity. The acidic pH (3.2-
4.2) of honey may help stimulate
Fibroblast activity within the
wound." Honey's osmolarity pulls
intracellular fluid into the wound,
which dilutes the honey. Glucose
oxidase is then activated, which
produces hydrogen peroxide at low
levels, thereby decreasing bacterial
growth. The hydrogen peroxide
produced is 1000 times lower than
the 3% solution typically used to
clean wounds,1'" but even at this
low concentration, the hydrogen
peroxide maintains its antimicrobial
activity." '
The antibacterial effect of
honey is determined by its plant
source and how it was processed."
ViuJlai and Menon ~ compared the
antibacterial activity of four different
types of honey—khadikraft
honey, manuka honey, heather
honey, and local honey from beekeepers
in a south Indian village—
against a total of 152 strains of
Pseudomonas cultured from diabetic
ulcers, infected burns, and
blood. The four honeys were diluted
widi sterile Mueller-Hinton agar
to obtain concentrations ranging
from 1% to 25%. Nutrient agar
without honey served as the
growth control and chloroxylenol
was the antiseptic control The
lowest concentration of honey that
prevented growth on the isolates
was recorded as the minimum
inhibitory concentration (MIC).
Khadikraft honey was the most
effective against P aeruginosa, with
an MIC of 11%; an MIC of 20%
was needed for the other three
honeys. Pseudomonas species are
frequently resistant to antimicrobial
therapy, but honey that has an
MIC of 10%-20% is effective in
preventing its growth in wounds. "
Although chronic inflammation
appears to decrease when
honey therapy is used, clinical
studies have not been able to clearly
identify how this anti-inflammatory
effect occurs." Monocytes are
activated by honey to release interleukin
(II.)-6, IL-1, and tumor
necrosis factor-1.'4 Pain is reduced
in the wound because of the
decreased edema, which improves
circulation. Subrahmanyam et af
compared honey with silver sulfadiazine
in a randomized controlled
trial (RCI) in 60 patients
with burns, and found that honey
decreased free radicals stimulated
by excessive inflammation, thereby
reducing scarring.
Wound debridement by honey
has been noted through several
mechanisms. Autolytic debridement
occurs because of the extra
moisture pulled from lymph fluid.
The osmotic action cleanses the
wound base and softens slough
and necrotic tissue 11 Hydrogen
peroxide produced by honey
chemically also debrides the
wound; the honey reacts with ferrous
ions, producing the radical
hydroxy!, which causes antibacterial
activity.••' In an RTC comparing
the effectiveness of manuka honey
and hydrogel dressing in 73
patients with necrotic lowerextremity
ulcers infected with S
aureus (n = 41), MRS A (n = 16), or
P aeruginosa (n = 16), MRSA was
eliminated in 70% of the manuka
honey-treated wounds versus 16%
of the hydrogel-treated wounds
after 4 weeks.' P aeruginosa was
eliminated in 33% of honey-treated
wounds versus 50% of the
hydrogel-treated wounds. The
authors concluded that when the
slough is debrided and MRSA is
eliminated, the infection rate is
decreased.
The moist environment cieated
by the honey protects the wound,
reduces infection rates, reduces
pain, debrides necrotic tissue, and
promotes granulation tissue formation.''
Epithelialization can
occur on the surface of the wound
rather than below the eschar, as
occurs in dry wounds. The wound
bed is protected by honey's high
viscosity, which provides a barrier
to infection, and by the osmotic
activity of honey, which promotes
autolytic and mechanical debridement."
2' Honey also reduces
wound odor. When honey is used
to treat wounds, glucose, rather
than amino acids, is produced as
the bacteria metabolize serum and
dead cells. Lactic acid is then produced,
which is less malodorous
dian ammonia, amines, or sulfur
compounds.'4
Synthesis of the Literature
A systematic literature search was
done using the electronic databases
CINAHI. and Medline and the
Web engine Google Scholar and
the key words honey, wounds, and
chronic wounds. Thirty-four articles
were reviewed and assessed for
validity The authors evaluated

RCTs and case series to ascertain
the effect of honey on chronic
wounds such as lower-extremity
ulcers, pressure ulcers, bums, diabetic
ulcers, and slow-healing
wounds in oncology.
Lower-extremity Ulcers—In a
comparative study, Cethin and
Cowman-' used manuka honey to
treat 8 patients with chronic leg
ulcers that had not shown
improvement with other wound
care for 4 weeks. Wound odor was
eliminated after the first honey
application, pain duration was
decreased from 2 hours to 30 minutes
(per patient report), and the
size of the wound was reduced by
54.8% after 4 weeks of therapy.
Smith et al-'" applied Medihoney to
11 chronic lower-extremity venous
ulcers that had failed to respond to
various treatments, including compression,
topical silver, non adherent
dressings, and antibiotic
therapy. All of the wounds healed
after 3-6 weeks of continuous treatment.
Robson et al'5 found that the
average time to healing was 100
days in the Medihoney group versus
140 days in the standard-therapy
(control) group for lowerextremity
ulcers.
In 3 case studies of patients
with leg ulcerations, use of
Medihoney promoted significant
healing over 2-8 weeks and
reduced pain (per patient report)
and infection (per repeat swab cultures)
in ail cases." In a study of 6
patients with non-healing wounds,
use of honey produced the favorable
outcomes of granulation and
reduction of bacterial burden over
a mean of 4 weeks. ' One patient in
this study who had been experiencing
severe pain was able to stop
using an opioid analgesic after 17
days of honey gel treatment and no
longer needed any analgesic after 6
weeks of treatment. Use of honey
achieved the goals of reducing bacterial
load, inflammation, and
pain. By contrast, in a study conducted
on patients over a 12-week
time period, kill et a!-"' found that
honey with compression, compared
with compression alone, did
not significantly increase healing
of venous leg ulcers.
Diabetic Ulcers—Honey was
used in an elderly man with chronic
diabetic heel and forefoot ulcers
of 14 months' duration."' The
patient had lost two toes, had
undergone four surgeries, and had
been hospitalized 5 times in
attempts to heal the ulcers.
Cultures of the wound were positive
for MRSA, V'RK, and Pseudomonas,
Honey was applied daily;
after 2 weeks, granulation tissue
was noted. The ulcers resolved over
12 months.
Pressure Ulcers—Van der
Weydenw used honey dressings to
treat 2 patients with pressure
ulcers. One patient had a stage 3
ulcer and the other patient had a
stage 4 ulcer; both patients' ulcers
healed after 8-11 weeks of treatment.
The patient with the stage 4
sacral wound had been treated for
4 weeks with a hydrocolloid dressing,
with little effect. However,
after 1 week of honey treatment,
the necrotic tissue began to break
down and after 3 weeks, the
necrotic tissue was gone. Granulation
tissue was noted after 4
weeks. The other patient had been
treated with a hydrocolloid dressing
for 3 weeks, with no improvement.
One week after starting the
honey dressing, improvement was
noted, and after 23 days, the
wound was shallow and granulating.
Acton" used honey to debride
pressure ulcers, with favorable
results. In one case in which a
necrotic pressure ulcer had been
present for ) month, the necrotic
tissue was absent after 5 days of
treatment. In another case, a
necrotic hip wound was clean after
8 weeks of honey use. A 5-week
RCT assessed the use of honey in
15 patients with 25 stage 2-3 pressure
ulcers versus ethoxy-diaminoacridine/nitrofurazone
in 11
patients with 25 stage 2-3 pressure
ulcers.0 The honey-treated group,
relative to the control group, experienced
approximately 4 times the
rate of pressure ulcer healing.
Burns—Subrahmanyam et al
treated 100 patients with burns
with a honey dressing or a silver
sulfadiazine dressing. At 7 and 14
days, greater healing was noted earlier
in the honey group than in the
silver sulfadiazine group. The silver
sulfadiazine group showed persistent
infection on bacterial cultures,
whereas cultures in the honey
group were 90% sterile. These
authors reported that 50 patients
with bums treated with early exci
sion and skin grafting instead of
honey had better functional and
cosmetic results after 3 months.
Wounds in Patients with
Cancer—Honey has been used to
treat slow-healing wounds in
patients with cancer, particularly in
neonate and pediatric populations.
In a study by Simon et al,,: honey
was found effective against nosocomial
wound infections. These
investigators studied wound cultures
growing MRSA, VR1-, and P
aeruginosa from 14 patients whose
slow wound healing was related to
chemotherapy and radiation toxicity,
malnutrition from nausea/
vomiting, mucositis, or infection.
Healing was noted after an average
use of 22 days in all wounds.
Patients and their parents were
pleased with the results.
Implications for NP Practice
Assessment—The TIME frame-

TABLE 2
FREQUENCY OF HONEY DRESSING CHANGES
Type of Honey Dressing Amount of Exudate Frequency of Dressing Changes
Honeycolloid Light drainage Change every 4-7 days
Honey gel/ointment Light to moderate drainage Cover wi*h an occlusive dressing and change daily
initially and every 2-3 days as drainage decreases
Honey alginate Moderate to heavy drainage Change daily initially and then extend to 2-3 days
as drainage decreases; change outer dressing pm
work for wound healing, developed
by Schultz et al," focuses on
preparing the wound bed by modifying
factors that delay or prevent
healing. Wound-bed preparation
includes management of 4 factors:
T = nonviable or deficient tissue;
I = infection or inflammation;
M = moisture imbalance; and
E = a non-advancing or undermined
wound edge.
NPs can use this framework in the
office to aid in assessment of
wound healing.
Choosing an \npropriate
Dressing —Honey dressings are
available in different forms, the
type used depends on the amount
of wound exudate." Wounds are
first cleaned using a facilityapproved
wound cleanser. The
outei margins are protected with
skin prep. Hie dressing is applied to
fit within the wound margins. For a
lightly draining wound, use of a
honeycolloid (non-adhesive) without
a cover dressing is suggested.
For a lightly to moderately draining
wound, use of a honey gel/ointment
and an occlusive dressing designed
to maintain a moist environment is
indicated. One challenge with use
of a liquid/gel honey is ensuring
that it stays in place; this preparation
may not be optimal for a leg or
abdominal wound. Frequency of
dressing changes depends on the
amount of drainage (Table 2). An
outer dressing that becomes saturated
is changed promptly to avoid
maceration of the peri-wound skin
and to prevent contamination. As
drainage decreases, dressings are left
on for longer periods of time, typically
4-7 days/1 For moderately to
heavily draining wounds, another
available dressing is Medihoney, a
5% calcium alginate and 95%
Lepiospermum honey that is frequently
used on lower-extremity
ulcers under a compression wrap.5-"
Although honey is generally
safe when used to treat wounds, a
few contraindications exist. Patients
with a known history of allergy to
honey or bee venom should not
use honey dressings. Patients widi
DM need to monitor dieir blood
glucose levels more frequently
because of the risk for hyperglycemia.'"
Furthermore, honey
should not be used on stable, dry
eschar on heels, as diis is the body's
natural protection, or on wounds
that need surgical debridement/-'
Evaluation of Therapy--As
with any topical dressing, these
questions must be answered when
assessing the effectiveness of honey
in treating a wound: (1) Have redness
and swelling (ie, inflammation)
decreased? (2) Has pain
decreased? (3) What is the condition
of the surrounding skin? Is it
improving? (4) Is the number of
dressing changes decreasing over
time? (If not, the honey may not
be effective because of the amount
of drainage.) (5) Has the necrotic
tissue diminished? (6) Is the
wound odor decreasing? (7) Is the
treatment cost-effective?1"' F.ven
though honey has atuibacterial
properties, systemic antibiotics
may still be needed. Monitoring
the wound is required.
Implications for Education
Nurse practitioners and wound
care nurses must be educated
about the use of honey and its
indication for the treatment of
chronic wounds. Honey dressings
are easy to apply, non-adherent to
the wound base, and less painful
than other dressings on removal."
Honey can be used in cavity
wounds or a sinus tract because the
residual can be cleaned out at
dressing changes. 1 loney is appropriate
for wounds with moderate
to heavy amounts of drainage, with
slough or eschar needing chemical
debridement, and with an odor/'11
Honey for wound treatment must
be of a medical grade that is regulated
safe, effective, and cast-effective.
Implications for Research
Further studies specifically RCTs,
are needed to assess the use of
newly developed honey-impregnated
dressings. According to Simon et
af - many case studies, but only a
few RCis, have been reported

PRIMARY CARE
regarding the therapeutic use of
honey. More data are needed to
assess the effect of medical grade
honey at the molecular level (ie, its
antimicrobial and antioxidant
activity and elimination of free radicals
within the wound).11'
Additional clinical studies are
needed to determine optimal
dosage regimens for antimicrobial
efficacy.'
Conclusion
Use of honey as a treatment for a
variety of wounds is supported by
research. 1 loney has antibacterial
activity against MRSA, Pseudomonas,
and VRP,; it also reduces
odor and helps debride wounds.
Honey's anti-inflammatory activity
has been shown to reduce edema
and exudate and minimize scarring.'1
Honey can be removed
painlessly with use of a non-adherent
dressing. Use of honey is gradually
becoming more widespread
and may be well received by
patients, who perceive it to be a
natural product '" J •
Ann Reese is a wound care specialist
and geriatric nurse practitioner at
Greenville Hospital System University
Medical Croup in Greenville, South
Carolina. Deborah Willoughby, is an
undergraduate coordinator and professor
and Stephanie C. Davis is an assistant
professor, both at the School of
Nursing at Clemson University in
Clemson, South Carolina. Toni Silver is
a wound care specialist and Tad Venn
is a staff physician, both at Network
Geriatric Services in Spartanburg,
South Carolina. The authors state that
they do not have a financial interest in
or other relationship with any commercial
product named in this article.
References
1 Ueickoll I' lonas-" -i* \.u: ML. u ai
Racteria, biotilm .ir.it uunev a study of the effects
of honey on 'planktonic' and biolitm-embedded
chronic svound bacteria. Sel an 111'I I H«»it.
2007:1 ]V(5) 12,9-122.2.
10. l.uuesU. liseri. P.lTeaiveness of a honey dressing
lor healing pressure ulcers. / llc-u.'tif
(.ottUiMW Sun 2007:34(2) 1 84-190
Ostomy
11. Pieper [I, Honey-based dressings and wound
care an option ior care in the United duties. /
IVeiiiui' Ojlsmn U>ti:lwn::>4f d):r».>4 /i.Vs,
40. Van der Weyden KA. lite uv of honey lot he
treatment of two patients with pressure ulcers, if' /
Cvmmunit)- Sun. 200.1;8( 1 2 )S! 4S20.
.11 Atron C Medihunes: a complete ssoutid bed
preparation product IJr / \rj.r..:.200iS:l 7( II j:S44-
S41S.
32. Simon A, Sotka K, \\tsz:iiewsky C et al.
Wound care svith antibacterial honey (Medihoney)
in pediatric liemaloloys omniums
Ciliicer 200fvl4(l):91.97.
.Su/'pn/t I. c
33. schult/. C Moziiigu l>. Kiiiiwiii'lli M, Cla.stori
K Wound healinjt and IIMf (less concepts and
suciitific a[ip!icaiicis. iVtuniii fie;j,ur lif^'ii
2005:13(4 supplj.S I -Mi
34. Lay-flume k Honey m svou:ui iaie: effects
cliniial application and patient benefit Br 1 \::
200t-,-!7( 11 ).s

COMMENTARY P e o l / l M M : £ Jowe^AL fr.aay.July2?. 20D. B7
I can heal wounds with honey and so can you
ALLEN DENNISON
T
he Crowne Plaza Hotel in Warwick
resembles a decent beehive even on
a slack day. It is swarming with conferees
and employees moving in and
out of chambers consuming sweet food.
Some people arrive by air from nearby T.F.
Green AiTport on low-cost fares. There is a
high soda! organization.
Next week, on July 25-29, management
will show extreme cooperation in welcoming
20 beehives and 500 beekeepers for the annual
meeting of the Eastern Apiculture Society.
They will have talks on Colony Collapse Disorder,
practical beekeeping including a bee
yard, the business of keeping an apiary and
treating illness with bee products and stings.
On Wednesday they will be regaled by
Rhode Island's own Charlie Hall and the
Ocean State Follies, who will sting them all in
a show they will not soon forget. If you have
even a passing interest in bees, I recommend
that you go to the Web site eastemapiculture
.org and sign up for a day or two.
I am presenting my literature review and
work among the elderly in healing wounds
with honey, based on 30 years of office practice
and work as a medical director of Kvergreen
House Health Center, a nursing home
in East Providence. 1 remember a comic TV
routine with Met Brooks interviewing Sid
Caesar posing as a great Egyptologist. "So
professor, what is the secret of Tutankhamen's
Tomb?" Quipped Caesar, "Twenty
years of research and 1 should tell you?"
1 am going to tell you. Speaking of F.gyptian
tombs, did you know that urns of honey
were found undegraded in several tombs in
ancient Egypt? This tells volumes about the
amazing chemical nature of honey for
wound-healing, to say nothing of the long association
ol the bees and humans.
How does honey help to heal wounds and
why is it superior to neosporin, bacit racin and
prescription mupirocin (bactroban)? Honey
is bee spit but it is also their energy currency
and their bank account. Just as "people get
funny about their money" so, too, do bees get
funny about their honey. They hate bears,
bacteria and yeasts that may steal or spoil the
honey, For the bears they have stingers, for
the inicro-onjanisms they put amazing stuff
in the honey. They also seal the hive with an
antimicrobial substance called propilis.
Honey is a mixture of concentrated sugars
that immediately dehydrate a bacterial cell,
rendering it immobile, though without necessarily
killing it. Young Dr. Keith Monchik, of
the Orthopedic Service at Rhode Island Hospital
(RIH), went to Haiti with our team from
the Ocean State to treat earthquake victims.
They ran out of usual wound-carc creams
quickly but a senior military nurse reminded
the team that sugar packs from their rations
always work in a pinch to keep a wound from
getting infected through the same mechanism.
He reported gratifying results to the
RIH medical staff.
The high osmotic value of honey draws fluids
out of wounds. This decreases tissue pressure,
thus admitting more new blood, with, of
course, oxygen, as well as healing elements
> t^^il.m l« m,. nn vi,C*Om Will, AC fhP
fluid hits the honey, small amounts of hydn>
gen peroxide are produced, very toxic to bacteria
but not to fibroblasts and healing elements.
Honey derived from medicinally active
nectars such as tea tree and eucalyptus
may have additional value, and the Food and
Drug Administration has allowed their importation
and marketing.
Topical antibiotic creams and ointments —
both over the counter and prescription — are
commonly used for skin infections and
wound healing. These include neosporin,
bacitracin, "liipte-antibiotic" ointments and
mupirocin. They sterilize the wound but also
kill healing elements, leading to delayed
wound closure. And they often lead to confusing
red bypersensibviiy reactions.
Additionally, more and more bacteria are
growing resistant to antibiotics, which is a
terrific threat to all of us. Some are costly. We
should avoid these tike the plague. My wife,
Jane Denruson, M.D., is a pediatrician and
beekeeper. As our house experienced colony
collapse with drone migration of our four
boys to New York City and Washington, my
wife had the time to take the Bee Course offered
by Rhode Island Beekeepers Association
(RIBA) and start some hives. At the
monthly RIBA meetings I spoke with the older
beekeepers and was fascinated to learn of
honey's medicinal benefits. Some of the older
beekeepers suggested that 1 try using honey
mixed with Aquaphor ointment on my patients
with minor wounds and ulcers. Honey
at body temperature gets runny and dribbles
on clothes, leading to poor treatment adherence.
Aquaphor was already my favorite
healing ointment. It is well suited to mixing in
equal parts with honey because the lanolin
and mineral oil holds both aqueous and oily
parts together to treat a wound
Mixing large batches withmc help of my
mother in law, Jane Mackenzie, R.N., is
sticky business indeed. She helps me pot it
into little cosmetic jars for use in the nursing
home. We heal the aquaphor to 110 degrees in
the microwave but never put raw honey in the
microwave because it would rum its special
qualities. And 1 urge you all: "Do this al
hornet." You can't buv it already made up.
If I were to try to sell this as a medicament,
the Food and Drug Administration could
have me jailed and impound all my ointment,
because adequate studies on the effectiveness
and safety of this compound have not
been done. I lowever. iwo imported products,
Medihoney and Manuka Honey, have passed
FDA approval for wound-healing, 'lhey are
derived from the eucalyptus and tea tree
plant, respectively, whose nectars have supposedly
superior qualities. These honeys are
irriadiated lu inactivate trace amounts of botuiinum
toxin and bacteria.
i believe that raw honey needs no such
help and that such help might even he counter-productive
This treatment and the importation
increases the cost of treatment, witb
small nibes going for S5() to $100.1 insist on
the real thing when treating serious or stubbom
wounds hut for everyday use the product
from your home lab will work very well
on your cuts, burns and skin tears.
If you have diabetes and;or congestive
heart failure peripheral arterial-supply problems,
no ointment is going to help. The problem
is under the skin. You need a doctor for it.
I invite colleagues and hospitals to begin randomized
controlled trials on using local raw
honey head to head against imported honey
and the usual wound-care products. My hypothesis
is that we can control at low cost,
such superbugs as methacillin-resistam staphyllococus
aureus and vancomyrin-resistant
enterococcousand the emergence of further
resistant superbugs by avoiding the usual
antibiotics.
Meanwhile, we'd be encouraging the development
of new local hives, which are so
important to pollination — and thus plant life
and the broader ecosystem — nationally.
You may be interested in using hee stings to
treat disease and honey to desensitize yourself
to allergies. On July 2