Systematic review of the use of honey as a wound dressing.

Owen A Moore,K Seers,Henry J Mcquay,F Campbell,Lesley A Smith,R Andrew Moore

doi:10.1186/1472-6882-1-2

Owen A Moore, K Seers + Show 4 more

Open Access

https://doi.org/10.1186/1472-6882-1-2

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Abstract

ObjectiveTo investigate topical honey in superficial burns and wounds though a systematic review of randomised controlled trials.Data sourcesCochrane Library, MEDLINE, EMBASE, PubMed, reference lists and databases were used to seek randomised controlled trials. Seven randomised trials involved superficial burns, partial thickness burns, moderate to severe burns that included full thickness injury, and infected postoperative wounds.Review methodsStudies were randomised trials using honey, published papers, with a comparator. Main outcomes were relative benefit and number-needed-to-treat to prevent an outcome relating to wound healing time or infection rate.ResultsOne study in infected postoperative wounds compared honey with antiseptics plus systemic antibiotics. The number needed to treat with honey for good wound healing compared with antiseptic was 2.9 (95% confidence interval 1.7 to 9.7). Five studies in patients with partial thickness or superficial burns involved less than 40% of the body surface. Comparators were polyurethane film, amniotic membrane, potato peel and silver sulphadiazine. The number needed to treat for seven days with honey to produce one patient with a healed burn was 2.6 (2.1 to 3.4) compared with any other treatment and 2.7 (2.0 to 4.1) compared with potato and amniotic membrane. For some or all outcomes honey was superior to all these treatments. Time for healing was significantly shorter for honey than all these treatments. The quality of studies was low.ConclusionConfidence in a conclusion that honey is a useful treatment for superficial wounds or burns is low. There is biological plausibility.

Highlights

Superficial burns comprise a spectrum of injury severity depending on the depth of the wound and the proportion of the body affected
An exception is the subject of dressings and topical agents for chronic wounds, which has been the subject of systematic evidence collecting [4]
The main outcomes were the effects of honey and controls on healing time and infection rate, though antibiotic use and hospital stay were noted in some studies

Summary

Introduction

Superficial burns comprise a spectrum of injury severity depending on the depth of the wound and the proportion of the body affected. A burn may be superficial, involving just the epidermal layer of the skin. The extent of the injury is usually expressed in percent of total body surface area (TBSA) which is burnt. Burn wounds are most commonly dressed using a combination of paraffin-impregnated gauze (designed to prevent adherence of the dressing to the wound) and an absorbent cotton wool layer [1,2]. There is a dearth of good evidence about topical wound agents from systematic reviews of randomised trials [3]. An exception is the subject of dressings and topical agents for chronic wounds, which has been the subject of systematic evidence collecting [4].

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