Honey as a promising treatment for diabetic foot ulcers (DFU)

Abstract

Diabetic Foot Ulcers (DFUs) are complex, chronic wounds, which have a major long-term impact on the morbidity, mortality and quality of patients' lives. Individuals who develop a DFU are at greater risk of premature death, myocardial infarction, and fatal stroke than those without a history of DFU. Unlike other chronic wounds, the development and progression of DFU is often complicated by wide-ranging diabetic changes, such as neuropathy and vascular disease. These, along with the altered neutrophil function, diminished tissue perfusion, and defective protein synthesis that frequently accompany diabetes, present practitioners with specific and unique management challenges.Honey has been used for centuries in wound care. Its therapeutic properties are largely attributed to its antimicrobial and anti-inflammatory activities. This review provides an insight on the mechanisms by which honey affects wound healing. Honey is being used to treat many types of wound, including: traumatic wounds, surgical incision sites, burns, sloughy wounds, and pressure ulcers.The number of publications reporting the use of honey has increased. A great number of studies haves concluded that clinical evidence to support the use of honey in the treatment of superficial wounds and burns was of low quality. Other studies suggested that honey improved healing times in mild to moderate superficial and partial thickness burns when compared to conventional dressings.This was supported by a meta-analysis of systematic reviews of topical and systemic antimicrobial interventions for wounds. Of 109 evidence based conclusions, robust evidence was found to support the use of topical honey to reduce healing times in burns.Yet, there are many studies which did not indicate the positive result on using honey to treat DFU's. Therefore, more studies should be carried out in order to make a solid proof for using honey in treatment of DFU's.