Medical Grade Honey Research Articles

The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacterial isolates present in common foot and ankle wounds. An in vitro study

BackgroundDiabetic foot ulcers (DFUs) and post-surgical wound infections are amongst the most troublesome complications of diabetes and following foot and ankle surgery (FAS) respectively. Both have significant psychosocial and financial burden for both patients and the healthcare system. FAS has been reported to have higher than average post-surgical infections when compared to other orthopaedic subspecialties. Evidence also indicates that patients with diabetes and other co morbidities undergoing FAS are at a much greater risk of developing surgical site infections (SSIs). With the growing challenges of antibiotic resistance and the increasingly high numbers of resilient bacteria to said antibiotics, the need for alternative antimicrobial therapies has become critical.AimThe aim of this study was to investigate the use of medical grade honey (MGH) when altered to environments typically present in foot and ankle wounds including DFUs and post-surgical wounds (pH6-8).MethodsMGH (Activon) was altered to pH 6, 7 and 8 and experimental inoculums of Pseudomonas aeruginosa (NCTC10782), Escherichia coli, (NCTC10418), Staphylococcus aureus (NCTC10655) and Staphylococcus epidermidis (NCTC 5955) were transferred into each pH adjusted MGH and TSB solution and the positive and negative controls.ResultsMGH adjusted to various pH values had the ability to reduce bacteria cell survival in all pH variations for all bacteria tested, with the most bacterial reduction/elimination noted for Staphylococcus epidermidis. No correlations were noted among the pH environments investigated and the colony counts, for which there were small amounts of bacteria survived.ConclusionThis research would indicate that the antibacterial properties of honey remains the same regardless of the pH environment. MGH could therefore potentially be considered for use on non-infected foot and ankle wounds to reduce the bacterial bioburden, the risk of infections and ultimately to improve healing outcomes.

Active Leptospermum Honey as a Local Drug Delivery Agent in patients with Chronic Periodontitis: A Clinico-Biochemical Study

Background: Antibacterial agents have always been the part and parcel in the treatment of periodontal infection. One such known agent is Active Leptospermum Honey (ALH) which has been the most studied species of medical grade honey used for the treatment of wounds and burns. Therefore, this study revolves around evaluating the efficacy of active leptospermum honey as a local drug delivery (LDD) agent on probing pocket depth (PPD), relative attachment level (RAL), and periodontal pocket pH. Materials and Methods: Based on the study's inclusion and exclusion criteria, a total of 100 sites with probing pocket depth of ≥ 5mm in posterior region will be selected. The sites will be grouped as: Test Group: 50 sites, Control Group: 50 sites, following the assessment of baseline clinical and biochemical parameters. At the baseline appointment, each patient received full mouth scaling and root planning (SRP). They were called back after 48 hours. Following the assessment of biochemical parameters by using pH test paper strips, MEDIHONEY® was placed as a local drug delivery (LDD) agent in test sites. In control sites only SRP was done. Patients were recalled after 30 days following LDD to reassess only gingival index, plaque index and biochemical parameters. Patients were recalled at 90 days following LDD for the reassessment of all clinical and biochemical parameters. Results: Plaque and gingival inflammation reduced in both groups but test group showed more reduction. Pocket depths were reduced significantly in test site. There was significant pH reduction in test sites. Clinical attachment level was also seen to be improved in the sites which were tested. Conclusion: When administered locally, Active Leptospermum Honey demonstrated lessening of PPD, gingival index (GI), and plaque index (PI), as well as higher levels of clinical attachment (CA).

Intra-socket application of medical-grade honey after tooth extraction attenuates inflammation and promotes healing in cats.

Dental diseases are a major problem in cats and often necessitate tooth extraction. Medical-grade honey (MGH) has antimicrobial and wound-healing properties, and therefore the aim of this study was to investigate whether intra-socket application improved healing after tooth extraction. It was postulated that applying MGH would reduce inflammation, improve the viability of the surgical flap and enhance healing following tooth extraction. A prospective randomised controlled trial was performed in client-owned cats undergoing bilateral tooth extractions of the same element of the canine or (pre)molar tooth. A split-mouth design was used in which every animal served as its own control. After surgical extraction of the elements, the sockets on one side were filled with an MGH-based ointment (L-Mesitran Soft), whereas the contralateral side received no treatment (control). A mucoperiosteal flap was used on both sides, and simple interrupted monofilament sutures were placed. No antimicrobial drugs were administered. Clinical parameters (inflammation/redness, flap viability and wound healing) were subjectively analysed on days 3 and 7 post-extraction by a veterinarian blinded to the treatment. Twenty-one cats were included. MGH significantly decreased signs of inflammation (P <0.01), improved mucoperiosteal flap viability (P <0.01) and promoted wound healing (P = 0.01), at both time points. MGH was easy to apply and there were no adverse events. Intra-socket application of MGH after tooth extraction positively affects the surgical wound, as it reduces redness, improves flap viability and enhances wound healing. Applying MGH represents a potent adjuvant therapy to support intra-oral wound healing after tooth extraction.

Enhanced Bioactivity of Tailor-Made Glycolipid Enriched Manuka Honey.

Glycolipids can be synthetized in deep eutectic solvents (DESs) as they possess low water content allowing a reversed lipase activity and thus enables ester formation. Based on this principle, honey can also serve as a media for glycolipid synthesis. Indeed, this supersaturated sugar solution is comparable in terms of physicochemical properties to the sugar-based DESs. Honey-based products being commercially available for therapeutic applications, it appears interesting to enhance its bioactivity. In the current work, we investigate if enriching medical grade honey with in situ enzymatically-synthetized glycolipids can improve the antimicrobial property of the mixture. The tested mixtures are composed of Manuka honey that is enriched with octanoate, decanoate, laurate, and myristate sugar esters, respectively dubbed GOH, GDH, GLH, and GMH. To characterize the bioactivity of those mixtures, first a qualitative screening using an agar well diffusion assay has been performed with methicillin-resistant Staphylococcus aureus, Bacillus subtilis, Candida bombicola, Escherichia coli, and Pseudomonas putida which confirmed considerably enhanced susceptibility of these micro-organisms to the different glycolipid enriched honey mixtures. Then, a designed biosensor E. coli strain that displays a stress reporter system consisting of three stress-specific inducible, red, green, and blue fluorescent proteins which respectively translate to physiological stress, genotoxicity, and cytotoxicity was used. Bioactivity was, therefore, characterized, and a six-fold enhancement of the physiological stress that was caused by GOH compared to regular Manuka honey at a 1.6% (v/v) concentration was observed. An antibacterial agar well diffusion assay with E. coli was performed as well and demonstrated an improved inhibitory potential with GOH upon 20% (v/v) concentration.

Medical Grade Honey as a Promising Treatment to Improve Ovarian Tissue Transplantation.

Ovarian tissue cryopreservation is a female fertility preservation technique that presents major challenges for the maintenance of follicular viability after transplantation. The aim of this study was to evaluate and compare the application of L-Mesitran Soft®, a product containing 40% medical grade honey (MGH), with other strategies to improve ovarian grafts’ viability. For this purpose, bovine ovarian tissue was vitrified, warmed and randomly assigned to culture groups: (1) control, (2) MGH 0.2% in vitro, (3) MGH in vivo (direct application in the xenotransplantation), (4) vascular endothelial growth factor (VEGF 50 ng/mL) and (5) vitamin D (100 Nm), during a 48 h period. A sixth group (6) of fragments was thawed on transplantation day and was not cultured. The tissue was xenotransplanted into immunodeficient (Rowett nude homozygous) ovariectomized rats. Grafts were analyzed 48 h after culture, and 7 and 28 days after transplantation. The tissue was subjected to histological and immunohistochemical analysis. Treatments using MGH showed the highest angiogenic and cell proliferation stimulation, with cellular apoptosis, within a healthy cellular turnover pathway. In conclusion, MGH should be considered as a potentially effective and less expensive strategy to improve ovarian tissue transplantation.

When time does not heal all wounds-the use of medical grade honey in wound healing: a case series.

Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.

Revolutionizing non-conventional wound healing using honey by simultaneously targeting multiple molecular mechanisms.

Hospital-acquired infections and treatment-related wound complications constitute a tremendous burden for the health care system, particularly given the serious increase in multidrug resistant pathogens. Imagine that a large part of nosocomial infections can be prevented using a simple treatment. In this respect, honey is used mainly in topical cutaneous wound care because of its potent broad-spectrum antibacterial and wound healing activities. However, therapeutic use outside this scope has been limited. The current review provides an in-depth view of studies using honey outside the conventional wound care indications. Non-conventional routes of honey application include subcutaneous, intra-socket, abdominal, and oral administration in novel indications, such as post colon surgery, mucositis, and tooth extraction. Honey consistently demonstrates beneficial therapeutic activities in these novel applications, orchestrating antimicrobial and prophylactic activity, reducing inflammation and wound dehiscence, and inducing healing, epithelialization, and analgesic activity. Several molecular mechanisms are responsible for these beneficial clinical effects of honey during the course of wound healing. Pro-inflammatory effects of honey, such as induction of iNOS, IL-1β, and COX-2, are mediated by TLR4 signaling. In contrast, honey's anti-inflammatory actions and flavonoids induce anti-inflammatory and antioxidant pathways by inducing NRF2 target genes, including HO-1 and PRDX1. The molecular and biochemical pathways activated by honey during the different phases of wound healing are also discussed in more detail in this review. Variation between different honey origins exists, and therefore standardized medical-grade honey may offer an optimized and safe treatment. Honey is a valuable alternative to conventional antimicrobial and anti-inflammatory therapies that can strongly reduce nosocomial infections.

Office based inferior turbinate coblation treatment: a randomized controlled trial on effectiveness and tolerability of medicinal honey

Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.

Is it possible to use a 100% Medical Grade Honey in the premature babies?

Le proprietà curative del miele sono sempre più affermate nella medicina moderna, soprattutto nel trattamento di lesioni cutanee di varia natura come piaghe da decubito, ustioni e stravaso di farmaci. Esistono diversi studi sull’uso del miele nei pazienti adulti ma non esistono linee guida universali nella popolazione pediatrica e soprattutto in quella neonatale. Presso l’Hevi Pediatric Teaching Hospital di Duhok, Iraq, un prematuro di peso estremamente basso alla nascita, con lesioni al piede da stravaso di farmaco, è stato trattato con il Medical Grade Honey al 100%. Dopo 28 giorni, la lesione è guarita, senza ricorrere alla rimozione chirurgica del tessuto e senza complicazioni allergiche per il paziente. L’uso del miele nei prematuri deve essere ulteriormente studiato e preso in considerazione.

Preliminary Characterization of a Polycaprolactone-SurgihoneyRO Electrospun Mesh for Skin Tissue Engineering.

Skin is a hierarchical and multi-cellular organ exposed to the external environment with a key protective and regulatory role. Wounds caused by disease and trauma can lead to a loss of function, which can be debilitating and even cause death. Accelerating the natural skin healing process and minimizing the risk of infection is a clinical challenge. Electrospinning is a key technology in the development of wound dressings and skin substitutes as it enables extracellular matrix-mimicking fibrous structures and delivery of bioactive materials. Honey is a promising biomaterial for use in skin tissue engineering applications and has antimicrobial properties and potential tissue regenerative properties. This preliminary study investigates a solution electrospun composite nanofibrous mesh based on polycaprolactone and a medical grade honey, SurgihoneyRO. The processing conditions were optimized and assessed by scanning electron microscopy to fabricate meshes with uniform fiber diameters and minimal presence of beads. The chemistry of the composite meshes was examined using Fourier transform infrared spectroscopy and X-ray photon spectroscopy showing incorporation of honey into the polymer matrix. Meshes incorporating honey had lower mechanical properties due to lower polymer content but were more hydrophilic, resulting in an increase in swelling and an accelerated degradation profile. The biocompatibility of the meshes was assessed using human dermal fibroblasts and adipose-derived stem cells, which showed comparable or higher cell metabolic activity and viability for SurgihoneyRO-containing meshes compared to polycaprolactone only meshes. The meshes showed no antibacterial properties in a disk diffusion test due to a lack of hydrogen peroxide production and release. The developed polycaprolactone-honey nanofibrous meshes have potential for use in skin applications.

Medical-Grade Honey Outperforms Conventional Treatments for Healing Cold Sores-A Clinical Study.

Cold sores are nasolabial blisters caused by herpes simplex virus (HSV) infections. Novel therapies demonstrating simultaneously antiviral activity and improved wound healing are warranted. The aim of this study was to investigate the efficacy of medical-grade honey (MGH) for treating HSV-induced cold sores. A crossover trial was performed in patients with recurrent cold sores (n = 29). The majority (65.6%) of these patients experience four or more episodes per year, thus forming a valid self-control group. In this study, patients applied an MGH-based formulation (L-Mesitran Soft) on their cold sore at the onset of symptoms (62.1%) or appearing of blister (37.9%) and compared it to their conventional treatments. After complete healing, patients filled in a questionnaire evaluating healing, pain, and itching. The average absolute healing time was 72.4% slower with conventional treatment (10.0 days) compared to MGH (5.8 days). After MGH treatment, 86.2% of all patients experienced faster objective healing (6.9% similar and 6.9% slower) and the subjective healing score was higher in 79.3% of the patients (20.7% similar). If the patients normally experience pain and itching during their cold sores, these levels were lower with MGH therapy compared to conventional treatment in 72.7% and 71.4% of the patients, respectively. Moreover, 100% of the patients prefer MGH treatment over conventional treatment and will use it again on future cold sores. MGH is a promising alternative treatment for cold sores, likely by combining both increased antiviral and wound healing activities while alleviating pain and itching.

Potential effects of Saudi Shaoka (Fagonia bruguieri) honey against multi-drug-resistant bacteria and cancer cells in comparison to Manuka honey.

The global spread of antimicrobial-resistant infectious diseases and cancer are the most widespread public health issue and has led to high mortality rates. This study aims to evaluate and verify the antibacterial and antitumor activities of Shaoka and Manuka honey against pathogenic bacteria, human hepatocarcinoma (HepG2) and breast cancer (MCF-7) cell lines. Shaoka hone was analyzed using HPLC, UV–vis, and GC/MC, while antibacterial activity was measured by agar diffusion, broth microdilution methods, and Transmission Electron Microscopy (TEM). Antitumor activity was investigated morphologically and by MTT assay. According to the presented data of HPLC analysis, Shaoka honey was generally richer in polyphenolic components, the antibacterial activity showed that Shaoka honey is equivalent or relatively more active than Manuka honey against a broad spectrum of multi-drug-resistant bacteria. It inhibited the growth of ESBL Escherichia coli in the absence or presence of catalase enzyme with a concentration approximately 8.5%–7.3% equivalent to phenol, which supported the highest level of non-peroxide-dependent activity. The minimum bactericidal concentrations (MBCs) ranged between 5.0% and 15.0% honey (w/v). TEM observation revealed distorted cell morphology, cytoplasmic shrinkage, and cell wall destruction of treated bacteria. The selected honey exerted cytotoxicity on both cancer cell lines, inhibiting cell proliferation rate and viability percent in HepG2 and MCF-7 cancer cells, by different degrees depending on the honey quality, Shaoka honey competed Manuka inhibitory effects against both cancer cells. The obtained data confirmed the potential for use of Saudi Shaoka honey as a remedy, this well introduces a new honey template as medical-grade honey for treating infectious disease and cancer.

Medical grade honey: Hope for wounded white rhinos

South Africa is home to some of the world's most endangered wildlife, with the White rhinoceros (Cerathotherium simum) among its most threatened species due to its highly sought-after horn. Since the reproduction number is below the mortality rate, there is a decrease in rhinos year over year, urgently requiring changes and saving the survivors. In this study, the efficacy of medical grade honey (MGH) for wound care in rhinos was investigated.We presented a case series of seven rhinos with wounds of different etiologies, including gunshots and poaching. Four wounds were around the horns and three on the limbs. It was a challenge to take care and follow-up the wounds of these wild animals in their natural habitat. A well-balanced decision between the need of treatment and risk of immobilization is constantly evaluated. In the presented cases, MGH proved a novel tool with minimal intervention and maximal effectiveness. With the severity of the wounds taken into consideration, there was a rapid healing in all cases, while infection resolved when present. MGH creates a moist and anti-inflammatory wound environment, while promoting almost all aspects in the wound healing processes, such as autolytic debridement, angiogenesis and re-epithelialization. The efficacy of MGH has constantly been confirmed in other cases and literature as well. MGH forms a potent therapy for treating wounded rhinos, independent of the severity of the wound. The strong antimicrobial and healing properties make it an easy and versatile product that can be used in all kinds of wounds.

Treating (Recurrent) Vulvovaginal Candidiasis with Medical-Grade Honey-Concepts and Practical Considerations.

Recurrent vulvovaginal candidiasis (RVVC) is a relapsing vaginal fungal infection caused by Candida species. The prevalence varies among age populations and can be as high as 9%. Treatment options are limited, and in 57% of the cases, relapses occur within six months after fluconazole maintenance therapy, which is the current standard of care. The pathogenesis of RVVC is multifactorial, and recent studies have demonstrated that the vaginal microenvironment and activity of the immune system have a strong influence on the disease. Medical-grade honey (MGH) has protective, antimicrobial, and immunomodulatory activity and forms a putative alternative treatment. Clinical trials have demonstrated that honey can benefit the treatment of bacterial and Candida-mediated vaginal infections. We postulate that MGH will actively fight ongoing infections; eradicate biofilms; and modulate the vaginal microenvironment by its anti-inflammatory, antioxidative, and immunomodulatory properties, and subsequently may decrease the number of relapses when compared to fluconazole. The MGH formulation L-Mesitran Soft has stronger antimicrobial activity against various Candida species than its raw honey. In advance of a planned randomized controlled clinical trial, we present the setup of a study comparing L-Mesitran Soft with fluconazole and its practical considerations.

Medical-Grade Honey as an Alternative Treatment for Antibiotics in Non-Healing Wounds-A Prospective Case Series.

Non-healing wounds are usually colonised by various types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical-grade honey (MGH), which favourably affects the healing process with its antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory properties. The objective of this study was to evaluate the effect of MGH therapy on the healing process of non-healing wounds of various aetiologies and different wound colonisations. Prospective, observation–intervention case studies (n = 9) of patients with wounds of various aetiologies (venous leg ulcers, diabetic foot ulcers, surgical wound dehiscence) are presented. All wounds were treated with MGH and the healing trajectory was rigorously and objectively monitored. In all cases, pain, odour, and exudation were quickly resolved, which led to an improvement in the quality of life of patients. Despite the proven bacterial microflora in wounds, antibiotic treatment was not necessary. The effects of MGH alleviated the signs of local infection until their complete elimination. In eight out of nine cases, the non-healing wound was completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in wounds of various aetiologies and forms an effective alternative for the use of antibiotics for treating locally infected wounds.

LIQUID NITROGEN CRYOSURGERY FOR CUTANEOUS AND OCULAR NEOPLASMS IN KOI (CYPRINUS CARPIO) AND GOLDFISH (CARASSIUS AURATUS): EIGHT CASES (2018-2019).

Cryosurgery, also known as cryotherapy and cryoablation, is a promising surgical technique that employs highly localized freezing to destroy damaged and diseased tissue, including benign and malignant neoplasms. This procedure has been reported in the treatment of chromatophoromas, fibromas, and peripheral nerve sheath tumors in piscine patients. This study presents eight clinical cases of cryosurgery on cyprinid pet fish for a wide array of neoplastic masses, including chromatophoromas, squamous cell carcinoma, and sarcomas that were diagnosed by histopathology. Surgical excision of external masses, liquid nitrogen cryotherapy, injectable medications (meloxicam and danofloxacin), and topical medical-grade honey were applied to the patients after biopsy sampling. Five out of seven cutaneous cases and two out of three ocular cases had complete resolution without recurrence for at least three months posttreatment. Treatment was unsuccessful for two of the cutaneous cases in which the cutaneous masses were extremely invasive, resulting in severe ulceration and deep invasion into the coelomic cavity. One of the ocular cases involved a corneal mass that did not change in size and had no complications after treatments, suggesting that the treatment might be useful in limiting growth. The effectiveness of cryotherapy appears to correlate with the tumor type, as well as the stage and progression of tumor invasion.

USE OF TOPICAL TREATMENTS AND EFFECTS OF WATER TEMPERATURE ON WOUND HEALING IN COMMON CARP (CYPRINUS CARPIO).

Skin lesions are frequently diagnosed in fish medicine. Although systemic fish treatments exist, little is known about the efficacy of topical drugs on fish skin lesions. This study aimed to investigate the efficacy of medical-grade honey and silver sulfadiazine on skin lesions using common carp (Cyprinus carpio) as a model. Additionally, the effect of temperature on the wound healing process was evaluated. Punch biopsies were generated on six fish per treatment group under anesthesia. Treatment groups received one of the following topical medications after wounding: Dr. Nordyke's Wound Honey, MicroLyte Ag Vet, or SilvaSorb Gel. Nontreated positive control groups were similarly wounded but did not receive topical treatment. Fish were housed at 10°C to 13°C or 18°C to 21°C for 29 days. Macroscopic evaluation and image collection of wounds were performed on days 0, 4, 8, 12, 21, and 29 after wounding to compare changes in wound areas and inflammation over time. On day 29, tissue samples were collected for histologic analysis. From day 12 after wounding onward, wounds in positive controls maintained at 18°C to 21°C were significantly smaller (days 12, 21, and 29: P < 0.0001) compared with positive controls kept at 10°C to 13°C. There was an overall improvement in macroscopic appearance in honey-treated groups compared with positive controls on day 12 after wounding at 18°C to 21°C (P = 0.001), whereas with the use of Microlyte and Silvasorb, wounds had increased inflammation grades (P < 0.0001 and P < 0.0001, respectively) with enlarged wound areas (P < 0.0001 and P < 0.001, respectively) in comparison with positive controls on day 12 after wounding at 18°C to 21°C. This study suggests that topical use of medical-grade honey produces positive effects on wound healing in the carp model and higher water temperatures enhance the effects, whereas the use of silver sulfadiazine and lower water temperatures delays or worsens the wound healing process.

Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study.

Medical grade honey has previously been described as a prophylactic treatment for wounds. Local prophylactic treatment may be valuable in preventing post-operative incisional infections in horses undergoing colic surgery but has not been evaluated. To establish whether medical grade honey gel, applied on the linea alba intraoperatively, decreases the prevalence of incisional infections in horses undergoing colic surgery with no associated adverse effects. Prospective blinded randomised controlled clinical study. Horses older than 4months that underwent colic surgery between May 2017 and December 2018 and survived for >2weeks were included in the study. Horses were allocated 1:1 to treatment or control by block randomisation. In the treatment group, following closure of the linea alba, medical grade honey gel (L-Mesitran Soft® ) was placed in the incision followed by apposition of subcutaneous tissue and skin. Information regarding the incision and post-operative complications was obtained at five time points (24hours, 48hours, 5days, 14days and 3months). Eighty-nine horses were included in the study. No adverse effects associated with treatment were observed. Horses in the treatment group had a lower rate of incisional infection compared with the control group (8.2% vs. 32.5%, P=.02). The protective effect of MGH had a calculated adjusted odds ratio (OR) of 0.2 (95% CI:0.07-0.8, P=.03). The number of patients required to receive treatment to prevent one case of incisional infection (NNEB) was 4.7. Risk factors associated with infection included: younger age (OR=27, 95% CI: 2.3 to 306, P=.008) and diarrhoea 48hours post-operatively (OR=20, 95% CI: 1.5 to 277, P=.02). Follow-up was performed by different veterinary surgeons, hence not completely uniform. Local prophylactic treatment with medical grade honey gel in the abdominal incision during surgery is safe and may significantly decrease the prevalence of incisional infections in horses undergoing colic surgery.

Antifungal Activity of a Medical-Grade Honey Formulation against Candida auris.

Candida auris is a pathogenic yeast causing outbreaks in intensive care units with high mortality rates. The treatment of C. auris colonization is challenging due to high resistance rates. A potential alternative antifungal treatment is medical-grade honey. In this study the susceptibility of C. auris and other Candida species to the medical-grade honey-based formulation L-Mesitran® Soft was investigated. The medical-grade honey formulation reduced the growth of C. auris and other Candida species in a dose-dependent manner. This inhibition was not only due to the honey component, as treatment with an identical concentration of this component only was less effective and even stimulated the growth of C. albicans and C. glabrata, supporting the interpretation that supplements in the medical-grade honey formulation enhanced the antimicrobial activity. Increasing the concentration of the honey component to 40%, as is also present in an undiluted medical-grade honey formulation, lead to a 1- to 4-log inhibition of all Candida species. Unprocessed local honey reduced the growth of nearly all Candida species more strongly than medical-grade honey. C. auris’ susceptibility to the medical-grade honey formulation did not depend on geographic origin or resistance profile, although the multiresistant isolates tended to be more susceptible. Altogether, medical-grade honey formulation has a strong antifungal activity against C. auris and other Candida species. Future studies should demonstrate whether the treatment of open wounds or skin colonized with C. auris is feasible and effective in the clinical setting.

Can a medical grade honey sterilize an unsterilized honey

Background: Honey has reemerged as a new antimicrobial to treat and heal wounds. However, often it is found to be contaminated with microbes. Aim: To test whether the medical grade honey can be used as a method of sterilizing a fresh unsterilized honey. Methods and Materials: A freshly obtained raw honey of Apis Dorsata species was procured from Amit Jain&rsquo;s Centre of Apitherapy, Amit Jain&rsquo;s Institute of Diabetic Foot and Wound Care, Brindhavvan Areion hospital, Bengaluru, India. A sample of it was sent to microbiology laboratory to determine any microbial growths. Subsequently, 10 ml of medical grade honey that was sterilized with gamma irradiation was added to unsterilized honey and after 1 week, this mixed honey sample was sent for microbial analysis. Results: It was noted that the mixed honey specimen containing sterilized medical grade honey yielded growth in culture similar to unsterilized honey. Conclusion: Medical grade honey is ineffective in sterilizing fresh raw honey and should not be used as a method of honey sterilization.